2018 Winter Youth Retreat
For 4th-12th Graders
January 26-28
REGISTRATION FORM

WINTER YOUTH RETREAT for 4th-12th graders (campers will be divided by age groups for the weekend). GAGA ball in the snow, Bible study, the bouldering room, songs, worship, friends, indoor and outdoor games, lots of your summer camp favorites, and fun in the wonderful winter weather!

Cost: $120 per camper. Registration deadline: January 14th, 2018


Winter Retreat Online Registration

Complete this online form to reserve your place. The weekend begins with check-in from 7:00-8:00pm Friday evening and concludes Sunday at 1:00pm You will receive a confirmation letter, health history form, and what-to-bring list in the mail prior to the retreat.

Cancellations more than 2 weeks before the retreat - all but $20 of the registration fee will be refunded. Cancellations within 2 weeks of the retreat - Lutherlyn will retain $50 of the registration fee.

One Camper Per Online Registration Form.
Please complete the form below - Fields in red are required.


Camper Information

*REQUIRED
(Your name must also appear on your friend's registration)


Parent/Guardian & Contact Information

*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED


Program Selection & Secure Payment Information

*REQUIRED
$
*REQUIRED
*REQUIRED
Visa MasterCard Discover
*REQUIRED
/
*REQUIRED
? Visa®, Mastercard®, and Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.
*REQUIRED


Your credit/debit card information will be kept confidential. By submitting this form, you agree to the card listed above being charged. You will receive a confirmation email once your registration has been submitted. The information will be reviewed by our office staff before processing. Registrations will be processed within 24 business hours.

All questions in regards to the cost or other information, please contact the office at 724-865-2161 or email@lutherlyn.com.