2025 Youth Winter Retreat

Friday, February 28, 7pm - Saturday, March 1, 10pm | For all students in grades 6-12

At Living Vine Church

This is an overnight event!

Registration Special: $40 (Normally $50) per person!

Student Information

Student Name

Student Gender

Please select one option.

Male Female

Student Grade

Please select one option.

6 7 8 9 10 11 12

Special Dietary Needs, medications, disabilities, or other noteworthy information regarding your student that we should be aware of

Parent / Guardian Consent

First & Last Name of Parent or Guardian giving permission

Parent Email

This address will receive a confirmation email

Parent Best Phone Number

Medical Form & Parental Consent

LIVING VINE REGISTRATION FORM
This is the form we ask you to fill out once per school year for each student. If you have not yet filled out the form for the 2024-2025 school year, please click HERE to do so now, and then return to this page and click the checkbox below and continue registering for Life.

Living Vine Registration Form

Please select all that apply.

This Form Has Been Submitted

I consent to the above named student participating in this youth retreat, including staying overnight at Living Vine Church

Please select all that apply.

I consent

Payment

Registration Special: $40 (Normally $50) per person! $40.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Friday, February 28, 7pm - Saturday, March 1, 10pm

For all students in grades 6-12

At Living Vine Church

This is an overnight event!

Registration Special: $40 (Normally $50) per person!

2025 Youth Winter Retreat

Description

Please Fix the Following