Winter Xtreme- MS • Lakepoint Church

Date

February 7, 2025 - February 9, 2025

5 out of 30 remaining tickets available

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Registration

5 Remaining

Price
$170.00

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Leader Registration

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Price
$170.00

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Winter Xtreme 2025

First Name *

Tip: Student's Name

Last Name *

Gender *

Email Address *

Contact Number *

Street Address *

City *

State *

Zip Code *

Date of Birth *

Current Grade *

Tip: Choose...

Emergency Contact Number *

Tip: Numbers only

Emergency Contact Name(s) *

Tip: Type your answer

Medical Information & Release

Any allergies, medications, dietary restrictions, health information or other information that we should know about? *

Medical Release

As the parent / guardian of the above student, I hereby authorize any medical care deemed necessary by accredited physician / nurse or hospital while attending Lakepoint Church's Winter Retreats for either Middle School or High School students. In the event of any accident or illness I request that the people involved take any necessary action that seems appropriate at the time of the accident. I will not hold Lakepoint Church, retreat members or leaders, or the camp and its staff responsible for any cost that may arise. *

Legal Stuff

Photo/Voice Release

The above individual authorizes LAKEPOINT CHURCH to use any pictures (including photographic, motion picture, and electronic (video) images.) or voice recordings (sound or video) in any and all media including, without limitation, cable and broadcast television and the Internet, and for exhibition, distribution, promotion, advertising, sale, press conferences, meetings, hearings, educational conferences and in brochures and other print media. *

Please download, complete, and return the Health Form.

Leader Registration 0