Refresh 2024

July 28, 2024 1:00 PM - August 2, 2024 5:00 PM

Camp Refresh- Its just that, a time to refresh and re-center, to re-connect and reflect in your walk with God. Refresh occurs in an environment where you can engage and fellowship with friends and leaders, spending time at the beach worshipping God and learning, all while enjoying His creation thru surfing, shopping, scavenger hunting, and team competitions. Dont miss out on this amazing time getting REFRESHED before summer ends! Contact Zach Day with any questions or for information about scholarships and fundraisers. ph: 425-328-8775 e: zachd@crosswaterchurch.org

Type

Price

Quantity

Student Registration

2 Remaining

Price
$475.00

Quantity

Student Registration 0

Student Information

First Name *

Last Name *

Gender *

Date of Birth *

Grade (As of Sept 2024)

T-shirt Size *

Home Address *

Home City *

I'd Like to Request Scholarship Help *

Yes

Amount Requested

Would you like to particpate in fundraisers?

Parent/Guardian Information

Parent/Guardian First Name *

Parent/Guardian Last Name *

Phone Number *

Email Address *

Emergency Contact Information (OTHER THAN PARENT)

Emergency Contact Name *

Emergency Contact Phone # *

Crosswater Waiver and Medical Release

Medical Insurance Provider *

Policy # *

Doctor’s Name *

Doctor’s Phone Number *

Are There Any Medications That We Need To Be Aware Of? *

Please list:

Does the student have any allergies that we need to be aware of? *

Please list:

Release

I, the parent or guardian, I acknowledge the risks associate with the above event and herby give approval for my child to attend and participate in this event. I relieve Crosswater Community Church and all affiliated staff from any and all liability for sickness, accidents, or injuries while attending or being transported to/from activities. In the event of an emergency and I cannot be contacted I give my consent to the youth leaders to authorize medical help on site or at an appropriate medical facility. I give permission to Crosswater Community Church Student Ministries to use pictures / video of my child for the purposes of promoting the event experience.

Parent/Guardian Name *

Tip: By entering your name here, you are acknowledging/agreeing to the statement above

Today’s Date *