Document Sample
					To:       Pastors, Counselors, and Youth Directors

From: Christine D. Sanchez
      Central District Youth Coordinator

Re:       Central District Youth Spiritual Fall Retreat

Greetings in the name of the Lord! Enclosed you will find registration forms for the Central
District Youth Spiritual Spring Retreat.

What: Fall Youth Retreat (Take Over My Soul-TOMS is the theme)
When: Friday, November 5 - Sunday, November 7, 2010
Where: Trinity Pines Conference Center – Trinity, TX (80 miles north of Houston)
How Much: Registration is $70.00 and Late Registration is $75.00 (when you arrive at

Every participant (youth and adults) attending the retreat must submit forms AND $30
Pre-Registration/deposit by Saturday, October 23, 2010. Remainder of the balance
($40.00) must be paid upon arriving at the campsite. If forms and $30 pre-
registration/deposit are not received by Saturday- October 23, 2010; Each Participant will
pay late registration of $75.00.

         Sorry - No refunds.
         Pre-registration/Deposit may be transferred to another participant.
         Only money order, church check, or cash will be accepted.
         Money Order or church check should be made payable to: Central District UMYF
          c/o Christine D. Sanchez, 5827 Gomer Pyle, San Antonio, TX 78240
Before mailing, please go over all forms, rules and what to bring so campers,
parents/guardians will understand what each camper will need to enjoy the spiritual
retreat. A medical release is also included in the forms; please have youth or
parents/guardians include any information that may be necessary for our camp nurse to
attend campers in case of an emergency.
In closing, I am including some information that may not be familiar to campers who may
be attending a retreat for the first time. As well, please join me in prayer for the youth
that will be attending. Thank you and God bless you!
         D.C.Y.M.: District Council on Youth Ministries; youth elected to serve as servant
         D.C.Y.M. Coordinator: Adult appointed by District Superintendent to serve as a
          resource for council.
         Y.S.F.: Youth Service Fund; Monies raised for youth missions projects.
         Spiritual Retreat: A weekend set aside for youth to grow, explore and meet Jesus
          Christ as their Savior.

          Central District UMYF Spiritual Retreat –Trinity Pines - Trinity, TX November 5-7, 2010

                                  RETREAT REGISTRATION FORM

Name_________________________________________ Youth / Staff / Adult (please
Address_________________________________ City/Zip_______________________
Age____ Sex____ DOB__________ Grade______ First Time Camper?__________
Church____________________________ Pastor_______________________________
                                     MEDICAL INFORMATION
Name of Doctor__________________________ Phone: (                       ) ______________________
Medical History (i.e. diabetes, epilepsy, heart murmur, asthma,
Do you have any physical limitations? Yes / No (please circle)
Allergies (i.e. food, insects, etc.): ____________________________________________
Date of last tetanus shot: ___________________
Group or Family Hospitalization Insurance Co.: ________________________________
Insurance Co. Address: ____________________________________________________
Group #: _________________Policy #:_________________Phone:_________________
In case of emergency, call: _________________Relationship to
Secondary person to call: ___________________________ Relationship to youth:
                                      Permission Statement
I do hereby give permission for the camp nurse to administer over the counter
medication such as Tylenol, Motrin, medication for cough and cold, etc. as needed. In
the event of an emergency where medical treatment is required I give my permission to
the church staff or youth coordinator to obtain the services of a licensed physician.
Please attempt to notify me immediately concerning any such emergency. I hereby
release the retreat leaders, the participating church, its staff and counselors of any
liability in the event of accident or injury.

Parent or Guardian Signature: ________________________________ Date: _______________

          Central District UMYF Spiritual Retreat –Trinity Pines - Trinity, TX November 5-7, 2010

                                       COVENANT OF CONDUCT

I will agree to remain on the campgrounds of Trinity Pinesfor the entire retreat.*
I will attend all activities planned for the retreat.* (applies to youth & Adults)
I will dress appropriately (keeping in mind this is a Spiritual Retreat)
I will not use language that is offensive.
I will not participate in “initiations”, shave cream or pillow fights.
I will not smoke, consume any alcoholic beverages and/or use drugs during the
I will not use my CELL PHONE during the Retreat (My youth counselor/coordinator
will hold my cell phone during Retreat Activities)
IPODS, CD/CASSETTE players will be allowed only during FREE TIME.
I am aware that if I break any of the rules, my pastor will be notified and
appropriate action will be taken. I also understand that I am retreating from the
Outside World to get closer to God.
I__________________________, have read and understood the CONVENANT OF
CONDUCT above and I agree to abide by it.

____________________________                 ______________________________
(Counselor’s signature)                          (Camper’s signature)

Agreement with the intent to support:

____________________________ ______________________________
(Parent/Guardian’s signature)      (Pastor’s signature)

        Any youth at least 11 yrs. – 18 yrs of age; grades 6th – 12th grade.
        Adults who are at least 21yrs of age, or older can attend as counselors, staff, and chaperones.

        All counselors, sponsors, chaperones, drivers and non-staff adults must register and pay full registration
         fee if they stay over the weekend. (All Adults will remain on campgrounds)

   Pillow, sheets, sleeping bag, BIBLE, towels, toiletries, money for offering, BIBLE, jacket / sweater, BIBLE,
         Comfortable clothes/shoes, Christian attitude, spending money for Canteen. YOUR BIBLE!!!


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