JYM Retreat Registration Form-Via Email
Welcome! Please follow the recommended sign-up times listed on the Scheduled Retreats page. Please register for one retreat only. You will receive an email confirmation note (on average) three weeks before the retreat weekend. Please understand that registration is on a first come basis. If the retreat fills, and most do, I will send you notice that your child has been placed on a wait list. Thanks again. - Kevin
To use this form to sign your child up for the next JYM Elementary Retreat, please follow these steps:
After you send the Form using email, this page reappears. You're done! Thank you.
Kevin Lee
↓ Copy Form ↓
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Step 4: Complete Form | Step 5: Send Completed Form |
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| First Child's Name | |
| Date of Birth (mo/day/yr) | |
| Age | |
| Grade in School | |
| Health Form On File With Us? (yes/no) | |
| First Retreat With Us? (yes/no) | |
| Second Child's Name (If needed) | |
| Date of Birth (mo/day/yr) | |
| Age | |
| Grade in School | |
| Health Form On File With Us? (yes/no) | |
| First Retreat With Us? (yes/no) | |
| First Parent's Name | |
| Second Parent's Name | |
| Street Address | |
| City | |
| State | |
| Zip/Postal Code | |
| Home Phone | |
| Cell Phone | |
| Meeting Attended | |
| Parent's Email Address (Required) | |
| Is your child a vegetarian? Yes/No | |
| Is your child a vegan? Yes/No | |
| Any dietary restrictions that we should know about? If "Yes" please detail below. | |
| Notes:
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