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Horizon Winter Retreat 2020 on Friday, January 24, 2020 @ 5:00 PM

***If you only want to pay a deposit at this time, be sure you selected the deposit option from the drop-down in the Price field at the top of this form.

Select the option below to apply your early bird discount! This offer is good only through 12/31/2019.
1-16.00 

Please fill out student registration information below. Thank you!

*Gender:
*Grade:
*Birthdate:
*T-Shirt Size:
*Primary Church Campus:
*Parent/Guardian First Name:
*Parent/Guardian Last Name:
*Parent/Guardian E-mail Address:
*Parent/Guardian Cell Phone:
*Emergency Contact Name:
*Emergency Contact Phone:
*Emergency Contact Relationship:
*Special Needs or Medications:
Please explain special needs or medications:
*Allergies (food, drugs, etc.):
*Favorite candy: