2026 Fall Youth Retreat Registration

November 13-15 2026

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1. Church Name

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2. Main Contact Name: (Required.)

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3. Main Contact Email: (Required.)

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4. Main Contact Phone:

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5. Email of Responsible Adult who will be at Bluestone

NOTE: For each 1-7 youth, you need at least 1 adult. If your group has both male and female youth, you are asked to have at least one male and one female. For additional enteries, please statrt a new form.

Special Needs: If you have participants with special needs, please note below. These should also be noted on the medical forms participants bring.

Dietary Concerns/Food Allergies: Note below if you have participants with food allergies or those who are vegetarians or vegans, or have other dietary concerns. Allergies should also be included on medical forms.

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6. Participant

First Name

Last Name

Grade (A for Adult)

Gender

Special Needs

Dietary Concerns or Food Allergies

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7. Participant

First Name

Last Name

Grade (A for Adult)

Gender

Special Needs

Dietary Concerns or Food Allergies

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8. Participant

First Name

Last Name

Grade (A for Adult)

Gender

Special Needs

Dietary Concerns or Food Allergies

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9. Participant

First Name

Last Name

Grade (A for Adult)

Gender

Special Needs

Dietary Concerns or Food Allergies

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10. Participant

First Name

Last Name

Grade (A for Adult)

Gender

Special Needs

Dietary Concerns or Food Allergies

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11. Participant

First Name

Last Name

Grade (A for Adult)

Gender

Special Needs

Dietary Concerns or Food Allergies

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12. Participant

First Name

Last Name

Grade (A for Adult)

Gender

Special Needs

Dietary Concerns or Food Allergies

Register online as a group and pay by credit card or mail a check in to:

Presbytery of West Virginia
P.O. Box 11720
Charleston, WV 25339

Cost is $65.00 per person.
Payment should be received by noon Thursday, November 12. Please make checks payable to Presbytery of West Virginia.

Volunteer Information Forms and Release Authorizations for all registered adults must be returned with registration so that they can be completed before the retreat.

Contact Sarah Sanderson-Doughty, Connectional Presbyter, with questions at connectionalpresbyter@wvpresbytery.org.

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13. How would you like to pay?

Credit Card

Check

2026 Fall Youth Retreat Registration

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* 1. Church Name

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* 2. Main Contact Name: (Required.)

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* 3. Main Contact Email: (Required.)

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* 4. Main Contact Phone:

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* 5. Email of Responsible Adult who will be at Bluestone

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* 6. Participant

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* 7. Participant

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* 8. Participant

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* 9. Participant

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* 10. Participant

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* 11. Participant

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* 12. Participant

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* 13. How would you like to pay?

1. Church Name

2. Main Contact Name: (Required.)

3. Main Contact Email: (Required.)

4. Main Contact Phone:

5. Email of Responsible Adult who will be at Bluestone

6. Participant

7. Participant

8. Participant

9. Participant

10. Participant

11. Participant

12. Participant

13. How would you like to pay?