2013 Junior Senior Leadership Retreat

The CPBC Youth Ministry
JUNIOR SENIOR Leadership Retreat
Gatlinburg, TN
Contact Info: Church: 336-768-5870
Cell: 336-978-4686
email: jeff@collegepark.ws
Hey Juniors and Seniors, lets go!!
One of the best retreats of the year is our Junior Senior Leadership Retreat.
This year we will be going to a mountain house overlooking Gatlinburg. This
is a comfortable, fun, and different kind of place for our retreat!
Here's the deal. We are going to Gatlinburg to enjoy some great lodging
(including a Jacuzzi and pool table), have fun shopping and messing around
in Gatlinburg, and finding out exactly how God can use you to be a leader in
our youth group. It is going to be a great weekend and you need to get
signed up today.
So if you are a junior or senior, you need to be a part of this retreat. The cost
for the retreat is $110 and you need to get your money and permission form
to Jeff by Sunday, January 6. Check out additional information on the
youth web site. Get packed & get ready for a great weekend.
CPBC YOUTH MINISTRY 1701 Polo Road Winston-Salem, NC 27106!
Here is the info...
Who:
All Juniors and Seniors
What:
Leadership Retreat
When:
January 19-21, 2013
Where:
Mountain Cabin, Gatlinburg, TN
Why:
To have fun, grow closer as a
group, and learn how God can
use us
How Much:
$110 for the ENTIRE weekend!
(includes 2 nights lodging, meals
except 3 fast food restaurants,
transportation, and a surprise or
two.)
www.collegepark.ws
Junior Senior Leadership Retreat
Gatlinburg, Tennessee
CPBC Youth Ministry
January 19-21, 2013
SCHEDULE:
Saturday, January 19, 2013
2:00 PM
Meet at church
2:30 PM
Leave for Gatlinburg
Monday, January 21, 2013
6:00 PM
Arrive at CPBC
LODGING LOCATION:
We will be staying at a rental cabin in Gatlinburg, TN
WHAT TO BRING:
• Pillow (for the bus)
• Toiletries
• Comfortable clothes and shoes
• Flashlight
• Heavy coat or rain jacket
• Insurance Card
• Cell Phone
• Medical Release Form
SPECIAL ITEMS:
• Playing cards (Uno, Spades, etc.) and/or board games
• Sports equipment (football, baseball stuff, frisbee, etc.)
• Money for fast food meal going and coming from Gatlinburg and for lunch on Sunday
(3 total meals)
• Snacks to share, and any money for personal spending, shopping, etc.
VERY SPECIAL ITEMS:
•
•
•
Bible
Pen/Pencil/Notebook
A great attitude and a smile
EMERGENCY CONTACT INFORMATION
To contact Jeff directly:
Cell Phone (336) 978-4686
COLLEGE PARK BAPTIST CHURCH
MEDICAL/PERMISSION AND RELEASE FORM
(To be completed and notarized before departure)
NAME AGE
ADDRESS ZIP
GRADE (if in summer, grade just completed)
T-SHIRT SIZE In Case of Emergency Notify: Phone Phone Family Insurance Co. Policy # Polio Booster Measles (List dates if known)
Family Physician IMMUNIZATIONS: Tetanus Other Mumps PAST MEDICAL HISTORY
(Check giving appropriate information)
Asthma Sinusitis Bronchitis Kidney Trouble Heart Trouble Diabetes
Dizziness Stomach upset Hay Fever
Other Penicillin or other drug (Name) Insect stings/bites Previous operations or serious illness: Any current medications: (List) Special Diet: (Name) ALLERGIES: (List type)
Food
Poison sumac, oak, or ivy Childhood Diseases: Chickenpox Measles Whooping Cough
Other Mumps PERMISSION FOR TREATMENT AND DISCHARGE
My permission is granted for COLLEGE PARK BAPTIST CHURCH staff member or sponsor in charge of the Junior Senior
Retreat in Gatlinburg, TN on January 19-21, 2013 to obtain necessary medical attention in case of sickness or injury for
____________________________________ (Participant's Name). I/We, the undersigned, do hereby release, and forever
discharge all sponsors and COLLEGE PARK BAPTIST CHURCH from any and all claims, demands, actions or cause of
action, past, present, or future arising out of any damage or inquiry while participating in the event. We further accept
financial and physical responsibility for the return of our child(ren), should the adult supervision find it necessary to send
him/her/them home (as applicable).
Signature of Parent/Guardian
Date
NOTARY
County, North Carolina
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she signed the foregoing document for the purpose stated therein and in the capacity indicated:
Date:
(Official Seal) Official Signature of Notary
Notary's printed or typed name,
My commission expires: