Winter Blast 2019 Registration: 

Student Name *
Student Name
Phone *
Phone
Grade *
Gender *
Medical Permission Form
Parent Name *
Parent Name
I give permission for my student (named above) to participate in the Winter Blast Retreat held at the Hidden Acres Christian Center on Feb 1-3, 2019. Should emergency medical treatment be necessary, I authorize one of the adult leaders to act on my behalf and approve the appropriate treatment.
Parent Phone *
Parent Phone
Date *
Date
 

Cost and Registration Info:

Registration Deadline: January 18, 2019

Retreat Cost: $35

Late Fee: After January 18, 2019, there will be a late registration fee of $20 per student.