Rekindle 2023 MVP Youth Retreat

11/10- 11/12/2023 | Come enjoy a fun, faith-filled, and inspiring weekend for all youth grades 7-12!
Friday Nov. 10th - Sunday Nov. 12th 2023 7:30pm Fri - 11:30am Sun @ Kirkmont Center

E-Mail David Bartley for more information dbrev1@juno.com
Contact Info

 
 
 
 
 
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Church Association

 
 
Emergency Contact

 
 
 
 
Insurance

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Medical

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Accommodations

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Consent & Liability

I, the parent/guardian of the youth listed above give the MVP Rekindle Leadership Team and Kirkmont Center Staff permission to:

1. Provide medications brought to camp by parent/guardian or prescribed by a physician while in attendance. 2. Provide over the counter medications following the dosage and directions on medical container. 3. Without limitation, or obligation, any and all media, including photographs, film footage, or tape recordings, which may include my child’s image or voice for the purpose of art, advertising, education, or promotion or for any other purpose, and release the Presbytery from any claim or liability to that use. 4. Agree to hold harmless Maumee Valley Presbytery, Kirkmont Center, employees and volunteers for all claims alleging bodily injury or property damage occurring while the participant is at a sponsored activity. 5. Give permission, as necessary to search a camper’s belongings when the health, well-being, or safety of the camper or others requires it. 6. The youth on this form described has permission to participate in all retreat activities. I give permission to the MVP Rekindle Leadership Team and Kirkmont Center staff and employees to transport my child to the local hospital for emergency services. If I cannot be reached in an emergency, I give my permission to the physician to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for this child. 7. I understand the information on this form will be shared on a "need to know" basis with Rekindle retreat leadership. I give permission to photocopy this form. In addition, the retreat staff has permission to obtain a copy of my child’s health record from providers who treat my child and these providers may talk with the program’s staff about my child’s health status.





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Payments

To pay by check select the "PAY LATER" option.  Checks should be mailed to:
     Maumee Valley Presbytery
     P.O.Box 638164
     Cincinnati, OH 45263
 
 
 
 
 
 

Description

11/10- 11/12/2023
Come enjoy a fun, faith-filled, and inspiring weekend for all youth grades 7-12!
Friday Nov. 10th - Sunday Nov. 12th 2023 7:30pm Fri - 11:30am Sun @ Kirkmont Center

E-Mail David Bartley for more information dbrev1@juno.com