Fall Retreat 2026 Registration

Complete this form and pay the $15 Fall Retreat Registration in the product box below.
Until this form is completed and the registration paid, your teen is not guaranteed a spot.
Once you complete this form, you will receive an e-mail from Pastor Patrick with further instructions and details. We're looking forward to a great retreat experience!

Youth Full Name

Parent's Name

Parent's Email

Parent's Contact Phone

I understand that I will be paying $15 for Fall Retreat 2026 and that registration will not be complete until this payment is made.