7 Grade Retreat

th

Fri., October 24th - Sat.,

October 25th
@ The REFINERY
Attention All 7th Graders!
Join Wildside for an awesome overnight in the Refinery!
Event Details: Connect with your C-Group, connect with your awesome
 For 7th Grade Wildside Students Only
 Cost: $20 (Cash, Credit Card or Checks made payable to Saddleback Church)
 Overnight Event Including: Dinner, Fun activities, Music, General
Sessions, Group activities, Breakfast, and Experiential breakout sessions

To Register:
Pre-registration is required. Turn in your completed form and money to your
C-Group Leader @ C-group by 10/21.

Student Details:
Student Check-in: 6:00pm @ The Refinery. Meet your C-Group leader at your designated
meeting spot.
Student Pick up: 12 Noon on Saturday @ The Refinery.
Things to Bring: Comfy Clothes, Overnight Toiletries, Bible, Pen, Sleeping Bag & Pillow
tear off
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Student Name: _______________________________________________ Gender: __________ School: ____________________________

Parent(s) Name: ________________________________ Phone#: _______________________ Email: ______________________________

Emergency Contact: _________________________________________________ Phone #: _______________________________________

C-Group Leader(s): _______________________________________________________________________________________________

Parent Permission
I give my child, _______________________________________________________ permission to take part in the 7th
grade retreat October 24th -25th.
In the event that he or she is injured while participating, I do hereby authorize and consent to any x-ray,
examination, anesthetic, medical, or surgical diagnosis rendered under general or special supervision of any
licensed medical staff member under the provisions of the Medicine Practice Act.
It is understood that this authorization is given in advance of any specific diagnosis or treatment being
required, but is given to provide authority and power to render care which the aforementioned physician, in
his or her best judgment, may deem advisable. It is understood that effort shall be made to contact me, the
undersigned, prior to rendering treatment to my child, but that any of the above treatment will not be
withheld if I cannot be reached. This authorization is given pursuant to the provisions of section 25.8 of the
Civil Code of California. I understand the nature of this event and do hereby release Saddleback Valley
Community Church, or any of it’s representatives, from any liability for accidents or injury sustained by my
child in conjunction with this event.
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Signature of Parent / Guardian Date