Encounter Youth Retreat Registration

Student’s Full Name

Student’s Grade

Student’s T-Shirt Size

Food Allergies or Dietary Needs

Medical Conditions or Other Needs Leaders Should Know

Parent and Emergency contact fields

Parent/Guardian’s Full Name

Parent/Guardian’s Email

Parent/Guardian’s Phone Number

Emergency Contact’s Full Name

Emergency Contact’s Relationship to Student

Emergency Contact’s Phone Number

Parent/Guardian Permission and Liability Agreement

I am the parent or legal guardian of the student named in this form. I give permission for my student to attend the Encounter Youth Retreat with The New Bluffton Worship on November 20–22, 2026, including transportation arranged by the church and participation in supervised retreat activities.

I understand that travel and retreat activities involve risks, including accidental injury. I acknowledge these risks and agree that my student will follow the instructions and safety rules provided by church leaders and retreat staff.

In an emergency, if I cannot be reached, I authorize church leaders to seek necessary medical care for my student. I understand that I am responsible for medical expenses incurred on my student’s behalf.

I confirm that the information provided is accurate and that I have disclosed relevant allergies, medical conditions, and other needs. I understand that any additional forms required by the retreat organizer must also be completed.

Parent/Guardian Agreement

I have read and agree to the permission and liability acknowledgment above, and I give permission for my student to attend.

Parent/Guardian Full Name Confirming Agreement

Date of Agreement (MM/DD/YYYY)

Description

November 20–22, 2026

Encounter Youth Retreat
Epworth By The Sea | St. Simons Island, Georgia
For students in 6th–12th grade

Join TNBW Youth for a weekend of growing in faith, building friendships, and connecting with other teens! This year’s theme, “Masterpiece,” based on Ephesians 2:10, explores who God created us to be and the good things He has planned for us.

Students will enjoy worship, Bible study, morning devotions, small group conversations, a cookout under the oaks, free time, and an open mic coffee house.

Cost: $150 per student; $100 for each additional sibling. Meals, cabin lodging, a T-shirt, and retreat programming are included. Students must bring their own bedding and linens. Travel details and a packing list will be shared before the retreat.

Please complete this form by Sunday, October 11, 2026. A parent or guardian must submit a separate form for each student attending.

Interested in serving as an adult chaperone? Contact Youth Leader BJ Johnson for more information about serving and chaperone requirements.

Questions? Email BJ Johnson at bjyouthtnbw@gmail.com.

Encounter Youth Retreat Registration

Description

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