SENIOR HIGH FALL RETREAT 2026 REGISTRATION FORM

The deadline to register for Senior High Fall Retreat is Friday, October 30, 2026!

Student Name

Student Email

This address will receive a confirmation email

Student Cell Phone

Address

Grade

9 10 11 12 Adult Volunteer

Gender

Female Male

Have you been baptized?

Yes No

Shirt Size

Small Medium Large XL XXL

If you are visiting our MYM event with a friend, please list their name here:

TRANSPORTATION

Parents will drop off and pick up their students at
Mayfair Church of Christ. Group travel will be provided to and from the retreat by charter bus.

Drop-off - Friday, November 13th - 4:45pm
Pick-up - Sunday, November 15th - 11:00am

All students must travel on the bus unless prior arrangments have been made. Please contact sara@mayfair.org.

I will be attending retreat for:

Entire Weekend Partial Weekend

Use this area to tell us about any attendance conflicts or alternate travel plans that need to be approved:

ALL MEALS DURING OUR CAMP WILL BE COOKED AND SERVED BY MYM VOLUNTEERS

Please list any dietary restrictions, allergies or special needs here. Please contact Sara (sara@mayfair.org) for instructions if your student requires an alternate menu.

EMERGENCY CONTACT

Emergency Contact Name

Emergency Contact Cell Phone

BEHAVIOR POLICY/PARENTAL CONSENT/MEDICAL RELEASE

By registering for this event, I agree to abide by the expectations set up by the MYM Leadership Team and will strive with a Chirstlike attitude to do everything within my power to make this retreat a great experience for all those who attend. I agree to abide by the safety measures put in place for this camp.

Cell Phone Policy:

In order to foster a distraction-fee environment focused on faith, friendship, and spiritual growth, we are implementing the following cell phone policy:

-All student cell phones will be collected during check-in at the start of the camp or retreat.

-Phones will be safely stored and returned at the conclusion of the event.

-If a parent needs to reach their child during the trip, they can contact one of the youth ministers or designated adult volunteers.

-If a student needs to contact home, they may do so through a youth minister or adult volunteer.

I agree with the above:

Yes No

After you register for camp the retreat, your parents will be sent a Consent & Medical Release required for your attendance if you do not have a completed form on file. Please let your parents know to be expecting this form that they must complete online for MYM.

Parent's Email Address for Parental Consent/Medical Release Form:

COST OF RETREAT IS $125 AND INCLUDES EVERYTHING YOU NEED FOR THE WEEKEND - LODGING, FOOD, DRINKS, SNACKS, AND T-SHIRT!

Payment

SENIOR HIGH FALL RETREAT 2026 REGISTRATION FORM

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