JCM Spring Retreat / Come and See

Name *
T-Shirt Size *
Allergies / Restrictions
Allergic to any medications, foods, environmental, or other substances? *
Restricted from eating certain foods or participating in any activities? *
Emergency Contacts
Please list phone numbers in the order we should call.
Condition of enrollment:
I have read, understand and agree to the terms and conditions listed on this Emergency Contact Form and I understand it is my responsibility to provide accident and health insurance coverage and I will be financially responsible for all charges and fees for emergency medical treatment and/or transportation, regardless of whether my medical insurance covers such charges and fees.
I am willing to have a sponsor for this retreat. If yes, my cost will be $25. *
Date Signed *
Date Signed