Youth Group Fall Retreat 2024

Oct. 25-27 | Please fill out this form and click submit.

Who: LivingWaters Youth Group 6th-12th grade students & friends
What: A weekend of building on our relationship with God and friends
When: Friday, October 25th to Sunday, October 27th, 2024
Where: Meet at 22222 Dodd Blvd Lakeville MN on Friday @ 4PM; return Sunday @ 4PM.
The retreat will be at Camp Shamineau More info about the camp can be found at www.shamineau.org
Cost: $120.00 per student. Scholarships are available - please see Garret Roach

Parent Info

Parent first and last name

Parent Email

This address will receive a confirmation email

Parent Phone

Emergency contact name and phone number in case you can not be reached.

I am a legal guardian of the student I am registering for this event. They have my permission to attend.

Please select all that apply.

Yes

I give permission for pictures or video of my student to be used on LivingWaters website, Facebook, or other form of media. Use of photos or video will be highly ethical.

Please select all that apply.

Yes No

Student Info

Student Name

Student Grade

Please select all that apply.

6th 7th 8th 9th 10th 11th 12th

Student Phone Number

Student Email Address

Any food allergies?

Please select one option.

No Yes (if so list below)

List any food allergies

Medical Form

Medical forms are required.

Click this link for a copy of our church medical form.
Church Medical Form

Please upload completed medical form here. This is a required field.

Upload (8MB)

Camp Waiver

Camp Shamineau requires a activity waiver to be signed & certian health & insurance information.

Please click the link below to download a electronic version of the camp from.
Camp Waiver Form

Please upload the completed/signed camp waiver & form here

Upload (8MB)

Payment Info

Cost is 120.00 per student. Full payment or a 50.00 deposit per student is due by Sunday 10-20-24. Select your payment option below. Cash or check - checks made out to LivingWaters. Payments may be turned into Julie Peterson or Garret Roach.

Please select an option

Please select one option.

I'll pay by cash the full amount ($120) or the deposit ($50) on 10/20/24 I'll pay by check (made out to LivingWaters) the full amount ($120) or deposit ($50) on 10/20/24 Garret Roach has approved a scholarship for my student(s)

Description

Oct. 25-27

Please fill out this form and click submit.

Youth Group Fall Retreat 2024

Description

Please Fix the Following