Children’s Retreat Sign-Up

Crystal Springs Retreat Center

October 26-27 from 6:00 pm Friday to 6:00 pm Saturday.
Cost: $20 per child. Free for parents.

To register, please complete this form for each child who plans to attend the Ultimate KidConnection Retreat. All fields are required to ensure that your child is registered and included in the program of your choice.

Child Information






May KidConnection staff provide medical treatment?
Is the child covered by personal/family medical insurance?


Parent/Guardian Information










(this is our primary way of providing information to you)

Emergency Contact Information






Retreat Information

 
 

Photo Permissions

Please read the Photo Permission Agreement before continuing.
 
- or -
 
 
 
 

Participation Agreement