Impact Fall Retreat

November 12, 2021 - November 14, 2021

168 out of 250 remaining tickets available

<p>Impact East Texas is excited to have you for Fall Retreat 2021!  You are about to register for this event which promises to be an exciting time.   Expect a time of fun and refreshing as we build relationships with each other and with God.  Get ready for God to make an IMPACT!</p>

Type

Price

Quantity

Fall Retreat Registration Fee

168 Remaining

Price
$85.00

Quantity

Fall Retreat Registration Fee 0

Impact East Texas Fall Retreat 2021

General Information

FOOD ACCOMMODATIONS
All provided meals will be served in the cafeteria. Campers will be provided with breakfast, lunch and dinner on Saturday, and breakfast on Sunday. Due to the late start time on Friday night, there will be no dinner offered the first night; however, we will have the Concession Stand available after the evening service on Friday. The Concession Stand will be available most of the day Saturday. These are additional expenses, so please bring spending money.

***Food, drinks and candy are not permitted in the dorms***

HOUSING ACCOMMODATIONS
All campers will be staying in a dorm that will have a screened chaperone. Sleeping bags or blankets, sheets and pillows are recommended for bedding.We recommend bringing shower shoes and a toiletry bag. There are no laundry facilities available for campers. Please bring appropriate amounts of clothes.

CAMP STORE
Merchandise in our Camp Store include: Souvenirs, Candy, Food, Drinks and Impact East Texas Merchandise.

VISITORS WELCOME!
Visitors must check in with Camp Directors, so we can give you a visitor’s pass. Day visits are free. If you are eating with us in the cafeteria meals are: $5.00 for adults $2.00 for kids. Overnight stays are NOT permitted for visitors.

First Name *

Gender *

Last Name *

Date of Birth *

Age *

Mailing Address *

Mailing City *

Email Address *

Mailing State *

Church Name *

Pastor's Name *

Emergency Contact Information

Emergency Contact Name *

Emergency Contact Phone Number *

Student Medical Questionnaire

Insurance Company Name

Insurance Company Address

Insurance Policy Number

Name of Policy Holder

This student is in good physical condition and may participate in ALL physical activities *

Please list any and all activities that this student may not participate in *

This student may receive first aid or medication if deemed necessary *

Does this student take any medications? *

Please list all medications *

Tip: Please write the name, the dosage, and the frequency of the medication

Does this student have any allergies to medication? *

Please list all medications that this student is allergic to *

Does this student have any allergies to food? *

Please list all foods that this student is allergic to *

Does this student have any allergies in general? *

Please list any allergies that this student has *

Fall Retreat Rules

Parents and campers must agree to abide by the following rules in order to attend Fall Retreat:

1. The Fall Retreat Registration must be filled out completely and the Medical release signed by parent or guardian. YOU CANNOT ENTER FALL RETREAT WITHOUT IT BEING SIGNED.

2. The Youth Board reserves the right to decline any application submitted by a prospective camper.

3. Dorm assignments will be made on a first come, first served basis.

4. The girls’ dormitory is off limits to all male campers, and the boys’ dormitory is off limits to all female campers. NO EXCEPTIONS!

5. Each camper is required to attend all classes and services unless sickness is reported and their monitor gives permission.

6. Any sickness should be reported immediately to your monitor. In case of serious illness or accident, the parent will be notified immediately.

7. Any camper refusing to abide by the Fall Retreat rules will have their pastor and their parents notified, and the camper will be subject to be sent home at the parent’s expense.

***THERE ARE NO REFUNDS FOR CAMPERS WHO ARE SENT HOME***

8. DRESS CODE FOR LADIES : Dresses must come to the knees or longer and must have a sleeve. Slits will not be allowed above the knees. Shorts must be to the knees, or longer, and must be loose-fitting. Pants and capris must be loose-fitting. No cutoffs, sundresses, sleeveless blouses or tops. Offensive or suggestive attire will not be allowed, and no gothic dress. Pajamas may not be worn outside dorms. No body piercings or excessive piercings allowed. Yoga pants are not permitted!

9. DRESS CODE FOR MEN: Shorts must be loose fitting and to the knees. Shirts must have sleeves (no tank tops or sleeveless shirts). Offensive or suggestive attire will not be allowed, and no gothic dress. Pajamas may not be worn outside dorms. No body piercings or earrings allowed.

10. All campers are required to refrain from the display of carnal affection between campers while at Winter Retreat. No PDA.

11. All campers are required to stay in designated areas at all times.

12. Campers are not allowed to leave the campground unless given special permission by the Fall Retreat Director.

13. Any camper’s car brought to Fall Retreat must remain parked in the designated area until camp is over and positively no going to town and back without permission.

14. Each camper is responsible for keeping his/her dorm room clean. All rooms must be clean before campers leave at the end of camp

15. Only those working in the kitchen are allowed behind the counter.

16. The camp athletic director has charge of all the recreational equipment.

17. Parent(s) are financially responsible for damaged caused by camper's registered in their name.

18. All Campers are subject to the Fall Retreat Director and Monitors while at camp and while riding on the bus to and from the campground.

19. Official opening for Fall Retreat is @ 4pm on Friday and camp closes @ 12 noon on Sunday. Medical costs for any camper due to sickness or an accident outside of this timeframe will be at the expense of the camper/parent(s).

20. Fall Retreat has a zero tolerance policy in regards to alcohol, smoking or controlled substances! Campers who violate this policy will be sent home at the parent's expense.

21. Any unregistered person on the campground during the day will be asked to leave. Visitors are welcomed at the evening services; however, they are required to leave when lights are out.

22. There will be no fireworks allowed at Fall Retreat. Any found will be confiscated and not returned.

23. If a camper is caught outside after lights out, their pastor and their parents will be called and the camper will be subject to going home.
The parents shall bear the expense of their return.

24. There shall not be any water fights, pillow fights, or shaving cream fights at Fall Retreat unless there is a set time and place for this activity by the Fall Retreat Director.

25. All campers, monitors, workers, and staff will go through a head lice examination upon arrival. If anyone is found to have head lice they will not be allowed to enter camp.

26. All medication (excluding inhalers for asthma) must be given to the campground nurse upon admission to Fall Retreat.

27. No pregnant women will be allowed to come to Fall Retreat as a camper or monitor.

28. Cell phones will not be allowed at Fall Retreat.

29. Campers ARE NOT ALLOWED to share beds, push beds together or sleep in the same bed.

30. Any conditions not covered by the Fall Retreat Rules, shall be judged at the discretion of the Fall Retreat Director.

31. Anyone who stays overnight MUST REGISTER!

32. Tithe.ly will add a 3% fee to the registration.

May photos taken of this student during this event be used by Impact East Texas in future promotional materials, either in printed form or digital form? *

I agree to abide by all of the rules and regulations listed above. I understand that my refusal to obey the rules of Fall Retreat could lead to me being sent home without refund. *

I agree to abide by the rules

I do not agree and will just stay home

Student Electronic Signature *

Tip: This is your electronic signature. By typing your name you are agreeing to the information you provided on this form.

Parent/Guardian Electronic Signature *

Tip: This is your electronic signature. By typing your name you are agreeing to the information you provided on this form.