Winter Blast Teen Retreat Registration Form with Payment

Winter Blast Teen Retreat

Please register your Youth Group by filling the form below.
Full Name

First NameLast Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Church
Church Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
First Time Attending?
Waiver of Liability Form

After submitting this registration form, you will receive an email with a link and QR code to give to each participant parent/guardian to complete. It is a quick form. Each parent/guardian can complete one form for all their family members. If you have any questions or concerns contact the office at 603-786-9504. Thank you.
Health Form

We will not require health forms. Each church will be responsible for collecting emergency information for each participant. Please include emergency contact information and any allergies. Keep this information with you throughout the weekend. Thank you.
Download the What to Bring Handout. Make copies for each participant.
Payments are processed through Square. We will accept major credit and debit cards.

Beginning October 25, 2025 there will be a 3% fee for credit card charges on all purchases.
Options for payment
Cost is $175 per guest. Please select the estimated size of your group. A $10 deposit per participant is required to register your church or group.

Number of Participants

Deposit Only

$10.00 Quantity

Number of Participants

Pay in Full

$175.00 Quantity

Subtotal

Tax

Total