Please fill out one registration form per family. All lodging will be assigned on a first-reserved, first-served basis.

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* 1. Participant Information #1

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* 2. Participant Information #2 (leave blank if not applicable)

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* 3. Participant Information #3 (leave blank if not applicable)

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* 4. Participant Information #4 (leave blank if not applicable)

If you have more than four participants in your family please contact Retreat Coordinator, Aubrey Shuman at quinipetretreats@nyac.com.

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* 5. Emergency Contact Information (Please notify this person of his/her duties)

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* 6. Do any of the above participants have any medical needs or concerns we should be made aware of? If yes, please explain.

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* 7. Do any of the above participants have any dietary restrictions? If yes, please explain.

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* 8. Do any of the above participants have any special skills or areas of interest that they're interested in contributing to our Service Weekend? If so, please list. Ex: Gardening, power tool experience, etc.

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* 9. What is your connection to Quinipet?

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* 10. What meals will you be joining us for?

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* 11. What is your shirt size? T-Shirts are unisex, sizes Youth Medium - Adult 2XL

  Size
Participant #1
Participant #2
Participant #3
Participant #4

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* 12. Do you have any special housing needs? (Must have first floor, cannot climb into a top bunk, must be able to plug in a medical device, etc)

TERMS & CONDITIONS
  • I hereby enroll myself and/or my family members listed above with The New York Conference of The United Methodist Church Spring Into Action weekend and agree to the following terms and conditions:
  • All information supplied in this camper registration form is correct.
  • I recognize the risks associated with camp and the volunteer weekend, and do not hold The New York Conference of The United Methodist Church responsible or legally liable unless losses and/or injury results directly from the negligent or willful act of staff acting within the scope of their responsibilities.
  • The New York Conference of The United Methodist Church camps may transport me or my family in camp vehicles to and from an approved off-camp activity or trip, to pick-up or drop-off from the ferry, or in the case of an emergency.
  • I give permission and consent for me and my family to allow photographs and videos to be taken during the volunteer weekend activities. I further give permission and consent that any such photographs and videos may be published and used by The New York Conference of The United Methodist Church and its agents, to illustrate and promote the camp experience and/or camp programs.

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* 13. I have read and understand the terms and conditions as outlined above.

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