Youth Workers Retreat 2026

Youth Workers Retreat Registration

October 27-28, 2026
Retreat Name
Retreat Status
Contact Name

First NameLast Name
Gender
Email
Phone
Format: 000-000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Church/Ministry
Dietary Service Agreement

Camp can only prepare special Gluten Free/Dairy Free plates upon request in advance of your arrival, no other substitutions.

We are a peanut free facility but not nut free. For any other questions or concerns about severe allergies please contact office@campelim.com before you arrive.

Indicate your GF/DF requests below.
Dietary Request for {contactName}
Requests for other family are on the next page

Youth Workers Retreat Registration

Family Information

Adult Attendees

Minimum per Adult parent$25.00

Please pay a minimum of $25 per adult to attend.

Quantity
Item subtotal:

Donate to help cover costs of attending$150.00

Camp Elim is subsidizing $150 of the cost per adult to attend. If you would like to help cover these costs, choose the number of attendees you would like to help come to the retreat.

Additional attendees to cover
Item subtotal:

Enter coupon

Total $0.00

Add Info for other Family Members?
For each family member you're bringing, list their name, relation to you, age group, and a request for a gluten free or dairy free plate.
Family Members
Roommate Requests
Note: Do not add family here, choose yes above to add family.
In case of Emergency

Who should we contact in the event you are incapacitated? Do not list yourself.
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Format: 000-000-0000.
Anything Else We Should Know?

Youth Workers Retreat

Overview Schedule

Beginning Tuesday Morning

9:00 Continental Breakfast & Check-in
10:30 Worship / Message
11:30 Break
12:00 Lunch
1:00 Toolbox TalksFree Time
2:00 Free Time
- Zipline, High Ropes, Archery/Tomahawks
- Frappuccino, Coffee, Cocoa
- Take a nap, Basketball, Volleyball, Hike on your own
5:30 Dinner
6:30 Activity
7:30 Worship / Message
8:30 Activity/ Snacks & Games
11:00 Lights Out

Wednesday Morning

8:30 Breakfast
9:15 Worship / Message
10:15 Personal/Family Quiet Time
11:15 Break & Pack up
11:30 Grab & Go Lunch
See you next year!!

(Optional Monday night arrival is open for those wanting an extra night of personal retreat. No programming or meals offered for Monday night, arrange with office@campelim.com for an early check-in to spend the night)

Youth Workers Retreat Registration

Release and Understanding
Attendees:

{contactName},Contact,18+,{contactDietary}
{familyMembers}
I agree to the Activities Release

I hereby acknowledge my willful decision to attend Camp Elim and to participate in all activities. I will not hold Camp Elim or its agents liable for injury caused by common accident, illness or the rendering of emergency care. I give permission for my family members named on this form to participate in any off-site activities during camp and to be transported to and from these activities, including emergency situations (if any) by authorized vehicles.
I agree to the Medical Release

I understand that in the event of an emergency, every effort will be made to contact a responsible relative of the camper. In the event that contact cannot be made, I hereby give permission to the camp administration and the physician they may select to secure proper treatment for, to hospitalize, and to order such injections, anesthesia or operations as may be urgently necessary for myself and my family members named on this form. In the event of a claim, family insurance (if any) will be billed. Camp Elim’s insurance provides secondary coverage for injuries sustained at Camp.
I give permission to Camp Elim to use media (video or photographs) of my family for promotional purposes
Please note any exceptions to the Media Release.
Signature

By signing I agree to the statements in this form
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
No Robots
Balance Due: ${adultTickets}

Click Submit, you will be emailed a copy of your registration.

Payment Methods

Debit or Credit Card

Should be Empty:

Youth Workers Retreat Registration

Dietary Service Agreement

Youth Workers Retreat Registration

Adult Attendees*

In case of Emergency

Youth Workers Retreat

Overview Schedule

Youth Workers Retreat Registration

Payment Methods

Adult Attendees