Junior Elementary Kids One Night Retreat Topic: Joseph the Righteous Where: Skycroft Conference Center, Middletown, MD When: Saturday May 31st to Sunday June 1st, 2025 Cost: $108 per child Deadline for registration: April 29th, 2025 11:59 PM Parent / Emergency InformationParent/Emergency contact Name(Required) First Last Parent/Emergency contact Email(Required) Parent/Emergency contact Phone(Required)Child InformationChild's Name(Required) First Last Child's Food Allergies Health Insurance InformationPediatrician Name(Required) Pediatrician Phone Number(Required)Upload a picture of Health Insurance Card(Required) Drop files here or Select files Max. file size: 4 GB, Max. files: 2. Total Amount DueTotal Registration Due Amount: $0.00 Would you like to donate to support the Ministry? Total Due Consent(Required) I agree to the consent belowI give permission for my child , . to take part in the church trip described above. I hereby authorize the trip leaders to act on my behalf according to their best judgment in an emergency requiring medical attention, and I agree to take responsibility for the expense of such a procedure. I understand that while the leaders will try to act in their best ability, I will not hold them or the Church responsible for any accident or injury. I understand all reasonable safety precautions will be taken at all times by trip leaders during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold the Church or leaders liable for damages, losses, diseases, or injuries incurred by the subject of this form. Credit Card InformationCredit Card Cardholder Name Card Details