Clone of Summer 2026 Student

2026 Young Adults Retreat

Sugar Creek Bible Camp - 13141 Sugar Creek Bible Camp Rd, Ferryville, WI Dec 18th-20th, Ages 18-26ish
We are so excited to have you join us in December for our 2026 Young Adults Retreat.

The Retreat will be Dec 18th-20th of 2026. We will begin check-in at Sugar Creek on Friday between 3-5 pm and will conclude on Sunday at 11 am.

Our hope is to gather like minded believers for a weekend of worship, encouragement and building new and strengthing old friendsips.

This registration form will help us have all the needed information to prepare for an amazing Retreat together. You will be asked to complete your payment at the end of this form. Registration includes all lodging and meals for the weekend, swag and more.

We can't wait to meet all of our new friends at Midwest Messiah! Until then, if you have any questions, you are welcome to email us at MessiahMidwest@gmail.com.
Information
Name*

First NameLast Name
Email*

Confirmation EmailPlease retype your email to confirm.
Phone Number*

Area CodePhone Number
Birth Date*

MonthDayYear
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
T-Shirt Size (Adult Sizes)*

SmallMediumLargeXL2XL3XL4XL
Congregation/ Church
Emergency Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship*
Emergency Contact Phone Number*

Area CodePhone Number
RELEASE, WAIVER, AND AUTHORIZATION FOR MEDICAL TREATMENT
Event: Midwest Messiah Young Adults Retreat Dec 18-20th, 2026

The proposed activity provided by Midwest Messiah requires participation in physical exercises which are, by their nature, physically demanding. Many of the activities will challenge you and
cause surges in blood pressure and pulse rates. It is imperative that you are free of any heart
related or other diseases. Therefore, all participants must be free of medical or physical
conditions which might create undue risks to themselves or any others who depend on them. If there is any doubt about your ability to safely participate in this experience, you should have a physical examination.
Participant's Name:*

First NameLast Name
Participant's Signature*

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Date*

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Date
HEALTH STATEMENT
Event: Midwest Messiah Young Adults Retreat Dec 18-20th, 2026

The proposed activity provided by Midwest Messiah requires participation in physical exercises which are, by their nature, physically demanding. Many of the activities will challenge you and
cause surges in blood pressure and pulse rates. It is imperative that you are free of any heart
related or other diseases. Therefore, all participants must be free of medical or physical
conditions which might create undue risks to themselves or any others who depend on them. If there is any doubt about your ability to safely participate in this experience, you should have a physical examination.
Medical Info
Do you have any allergies, chronic illnesses, or medical conditions? If yes, please answer the next question.*

YesNo
List allergies, chronic illnesses, or medical conditions.
Do you use an inhaler or carry an epipen? If yes, please answer the next question*

YesNo
Please list inhalers used or needs of your epipen.
Dietary needs outside of a Biblically clean diet
Please explain any yes answers.
Payment

(Return Policy) 1. A 90% refund may be given for any reason for a cancellation received 45 days or more prior to the event. 2. A 75% refund may be given for a cancellation received 31-44 days prior to the event, if after discussion and a majority of the board of directors feels it is a legitimate need.  3. No shows or cancellations within 30 days of event are not eligible for refunds, unless discussion and a majority of the board of directors feels it is a legitimate need. 
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Young Adult$225.00

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2026 Young Adults Retreat

Information

Emergency Information

RELEASE, WAIVER, AND AUTHORIZATION FOR MEDICAL TREATMENT

HEALTH STATEMENT

Medical Info

Payment