Winter Retreat 2009

Please Review the following, fill out the forms and hand them in to J.L. The forms must
be completed in order for you to come on the retreat!!!

Any question just let me know!

Date and Time:

We will meet at Baker on Sunday, January 18th at 1:00. Once we have everything in
order, we will travel as a group down to Springville UMC in time for the 2:00-2:30
registration. **** If Parents are available to drive, please contact me*****

The next morning we will be done at Springville at 11:00 AM and will drive back up
together to Baker. We should be back at in East Aurora shortly after noon.

Winter Retreat Expectations:

Required events/activities: During the retreat there will be a number of sessions,
activities, and worship times. These meetings are not optional and we require that you be
with the group at all meetings. There will be free time throughout the event as well.

Behavior: We will be staying at Springville UMC. We will be guests in the facility and
are expected to treat the property correctly. At the beginning of the retreat we will go
over the rules and safety stuff for the retreat. At the retreat there will be a number of
leaders from other youth groups. It is important to respect these leaders just as you do the
leaders from Baker.

What to Bring?
- Sleeping bag and pillow
- Toiletries
- Bible, notebook, and a pen
- Appropriate clothing for a one-night stay including sleepwear.
- Medical Release Form/Permission Slip

What not to Bring!

- No fireworks, weapons, knifes, or guns
- NO drugs, alcohol, or tobacco products
 Permission and Medical Release Form
Baker Memorial United Methodist Youth Group

Name: _________________________________________

Home Phone #: (______)________________________________

Address: _______________________________________

City, State, Zip: __________________________________

Grade: _________________ Age: ___________________

I give my permission for my above named child to join the Baker Memorial United
Methodist Youth Group on the Winter Retreat 2009, taking place January 18th- 19th 2009
at Springville UMC. I understand that the group will be traveling by chaperone vehicles.

I hereby release Baker Memorial United Methodist Church, its staff, sponsors, and
volunteer leaders from responsibility and liability for any injury or illness that my child
may sustain during this activity. In the event of an emergency, I hereby authorize an
adult leader for this activity (J.L. Miller, Heidi Miller, Jeff Thompson, Katie Felton), as
agent for me to consent to any x-ray examination; medical, dental, or surgical diagnosis;
treatment; and hospital care advised and supervised by a physician, surgeon or dentist (as
appropriate) licensed to practice under the laws of the state where the services are
rendered, either at a doctor’s office or at any hospital. I expect to be contacted as soon as
possible.

Signature of parent or legal guardian: ____________________________

Date: ______________

Parent’s Cell Phone #:___________________________

Emergency Contact (other than parents) and #:___________________________