Teen Retreat Registration
Registration Options
*
Please Select
I am registering as a Teen Participant
I am registering as a Youth Leader
I am registering a group of teens/multiple teens
Your Information
Your Name
*
First Name
Last Name
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Your Email
*
example@example.com
T-shirt Size
List any and all allergies, life threatening conditions, and dietary needs
*
Group Information
Church/Group Name
*
Are you attending with a group or church?
*
Yes
No
What group (list teens) or church (list church name) are you attending with?
How many youth leaders are you registering/paying for today?
*
*Including yourself
How many teens are you registering/paying for today?
*
Youth Leader Information (Including yourself)
*
Teen Information
*
Payment Options and Total
Would you like to purchase the Retreat T-shirt
*
No
Yes (only select after August 1st, because the T-shirt is free if you register before that date)
How many T-shirts would you like to add?
*
The size(s) of the t-shirts will be pulled from earlier on this form. Shirts cost $16.50 and will be added to your total due today. Very limited t-shirts may be available at check-in.
Payment Options
*
Pay in Full (Teen) ($60)
Pay in Full (Youth Leader) ($30)
Form Calculation
Total
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next
( X )
USD
Description
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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