Youth Winter Retreat - January 31 - February 1, 2026

Participant Name

Registration Type (choose one)

Youth currently in Grade 6-12 Adult Chaperone (age 24 and up) - minimum of 1 required per local church group Young Adult co-chaperone (age 21-24)

Participant Date of Birth

Participant Grade Level

Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Chaperone

Participant Cell Phone for Winter Retreat Group Communications

Please share accommodations that will support full participation:

Please share specific food allergies or dietary restrictions:

Please share any other medical needs or allergies:

Youth Leader First and Last Name

Youth Leader Email

This address will receive a confirmation email

Local Church Full Name

Local Church Address

Local Church Association

Covenant Detroit Metropolitan Grand West Southwest United Northern I don't know my Association

Emergency Contact First and Last Name

Emergency Contact Phone Number

Emergency Contact Relationship to Participant

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

January 31 - February 1, 2026

Youth in grades 6-12 will gather along with chaperones from their local churches for the opportunity to connect with one another and the wider church on January 31 - February 1, 2026 at Haslett Community Church in the Lansing Area.

Meals, snacks, programming, recreation, sleeping space, and worship will be provided.

Retreat starts at 10:00am on Saturday and ends after worship on Sunday
Includes: service learning with Sleep in Heavenly Peace, Exploration of the local area, dinner, programming, Bible study, overnight lodging at Haslett Community Church, Communion, continental breakfast, worship, and boxed lunch to go.

Youth Winter Retreat - January 31 - February 1, 2026

Description

Please Fix the Following