After filling out the release, you will be able to pay for camp using this form.
Who: All High School small groups in South CT
When: Friday March 16th-18th
Where: Camp Kern which is located on 485 beautiful acres in the Little Miami River Valley of Southwestern Ohio. Here is the website for more details about the camp:
Cost: $50. This pays for two nights stay, all meals on Saturday as well breakfast on Sunday. Checks should be written Xenos Christian Fellowship. Money is due by February 13th.
Additional Details: Home Church leaders will be providing rides for the students to and back from the retreat. Upper classman students will also be providing rides. However if you are uncomfortable with this, we can make sure a leader is driving your student. We will be getting your son/daughter back between 10 a.m. and 1 p.m. There will be many college leaders as well as adults chaperoning this event. If you have any additional questions you can contact Brian Adams at 614-202-9541 or email@example.com. You can also contact Kristen Burton at firstname.lastname@example.org.
I give permission for my son/daughter to participate in the South CT Retreat March 16th – March 18th. Adult chaperones are active members from Xenos Fellowship and act in a volunteer capacity. I understand that in spite of the best and focused efforts of the volunteer adult chaperones to provide a safe and healthy environment for my child, circumstances may arise leading to unintentional injury or losses on the part of our child. I release Xenos Christian Fellowship and their agents from all claims and expenses arising out of, or resulting from, my child's participation during this event. I give permission for any medical personnel to render necessary emergency medical care for my child if I can't be reached or if my child needs immediate medical attention.
Please list all medications your child takes and any allergies. Please list your child's medical conditions, if any.