Bridge Youth

High School Spring Retreat

April 4-9, 2019


REGISTRATION FORM

Student Name *
Student Name
Because our students attend many different high schools, some students will be on Spring Break, while others may need to miss school on Friday, April 5th. Please check "Yes, I understand" below if you have checked your child's school schedule and understand the possible scheduling conflict. *
Parent or Legal Guardian Name *
Parent or Legal Guardian Name
Emergency Contact Phone *
Emergency Contact Phone
Participating Students are required to have a 2019 Bridge Medical Waiver signed prior to attending this trip. *
Would you like this form emailed to you (to the email provided above)?
I would like to be contacted about fundraising opportunities and/or scholarship information for my child *
(This event will cost $175/student and include housing, meals, and activities for 3 nights)
I would like information about providing a meal for this trip *
(Allergies, food restrictions and any other information Youth Leaders should be aware of)