Man Makers 2019 Retreat

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Name

Phone (no spaces or dashes)

Residence Hall + Rm# or Local Address+Zip

Which Campus do you attend?

Bowling Green Akron

(AKRON CAMPUS) Which LifeGroup do you attend?

Medical & Emergency Contact Info

Do you have any allergies, medical conditions or dietary needs we should be aware of?

If so, do you carry an EpiPen? Yes No

Name of Emergency Contact (can not be attending the retreat)?

Emergency Contact Phone

Relationship to you

Mother/Father Older Silbing (must be independent from parents) Aunt/Uncle Grandparent Spouse

Address, City + Zip of Contact (authorities use this if contact cannot be reached by phone)

Overnight Arrangements

We will be staying overnight at the Dublin Baptist Church, Dublin, Ohio. There are no beds or showers. Please be prepared with appropriate bedding for the floor as well as other necessary toiletries.

Ride Information

Friday transportation will be arranged through your Group, unless otherwise noted below. If you have not indicated that you were part of a Group and you need a ride, a Group will be selected for you based on where you live. Saturday transportation is not provided. If you are coming on Saturday, you must arrange or provide your own transportation. Check-in begins at 6:30 pm and the retreat will start around 8:30pm. Please be sure to eat dinner before you arrive. Snacks will be provided after the first evening session.

Are you able to drive with others in your car? (Please estimate space for luggage and sleeping materials.)

I am on the Music Team, Events Team, or Sound team. I need a ride. (Please be prepared to contribute gas money for your driver.) 1 person other than myself 2 people other than myself 3 people other than myself 4 people other than myself I will drive separately. I am arriving on Saturday. I have already made arrangements.

Additional comments

Payment

We don't want money to deter anyone from attending Man Makers. If you need financial assistance, H2O offers a scholarship up to half of the cost of the retreat ($10) with the completion of a scholarship application. Click here to fill out the scholarship application form: https://h2ochurchbg.breezechms.com/form/701b57. Have your scholarship information completed and approved before finishing this registration form. Email Alfonso Mack at alfonso.mack@h2ochurch.com with questions or for further information. If you would like to help other students attend the Retreat, please answer the appropriate questions below and include that donation in your payment.

Would you like to sponsor additional students or give a donation? Yes No thank you.

If so, please list the names of those you would like to sponsor or enter "anonymous". Then add that amount to your total payment when paying by selecting "other" in the payment options.

Are you receiving financial assistance from a specific student or city member? If so, please indicate by whom and how much.

Option

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

H2O Church Liability Statement

I certify that my participation in this activity will be voluntary. I understand that participation carries risks inherent both to such activities and to the location of the Jersey Baptist Church, New Albany, OH. For myself and any who would claim under me, I release and hold harmless Reliant Mission, Collegiate Church Network, and H2O Church Network, its trustees, employees, and agents and Dublin Baptist Church, Dublin, OH, its trustees, employees, and agents from any liability for loss, injury, or damage to my person or my property which may result from my participation.

I certify that I have read the above liability statement and accept the terms for my participation.

I Agree

Description

February 15-16, 2019

To register for the 2019 Man Makers Retreat please fill out the registration form.

Cost: $20
Full payment due with Credit Card, Debit Card, or Bank Transfer at time of registration.

If you are arriving Saturday AFTER breakfast, the cost is $15. Please select this option when making your payment.

RIDES:
Friday transportation will be arranged through your Group, unless you note otherwise. If you have not indicated that you were part of a Group and you need a ride, a Group will be selected for you based on where you live.

Saturday transportation is not provided. If you are coming on Saturday, you must arrange or provide your own transportation.

CHECK-IN:
Check-in begins at 6:30pm and the retreat will start around 8pm. Please be sure to eat dinner before you arrive.

Thank You!

Man Makers 2019 Retreat

Description

Please Fix the Following