Young Adult Retreat Registration Form Register – 2026 Young Adult Retreat The registration form for the 2026 Young Adult Retreat. Step 1 of 2 50% X/TwitterThis field is for validation purposes and should be left unchanged.Church Brooklife Church Fox River Church Story Hill Church Other Other ChurchPlease let us know your church affiliation for this retreat.Name(Required) First Last Address(Required) Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email(Required) Phone(Required) Food allergies or any additional information you think we may need to know.Registration NotePlease enter the names of the people with whom you’d like to share a cabin. If you have any other special requests please enter in this field. Consent(Required)This RELEASE of LIABILITY is made and entered into hereinafter designated PHANTOM RANCH BIBLE CAMP and hereinafter designated PARTICIPANT. I acknowledge that participation in the activity described above involves risk to the participant (and to the participant’s parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage, and financial damage. In consideration for the opportunity to participate in the activity described above (the “activity”), the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in, supervision if guardian of minor(s) and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by Phantom Ranch or its agents, employees, volunteers, or any other representatives (collectively referred to as the “sponsor”). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association. I have read this release of Liability and Assumption of Risk Agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. I also agree that I have the right to assign this agreement to all others listed on this form.Signature – Full Name(Required)Please sign acknowledging that you have read the activity waiver above.Payment information will be included on the next page, after you submit. Thank you.Retreat Fee Price: Payment Method(Required) Pay with check Pay with credit card
