Mini Methodists Registration

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Calling all M & M’s! It’s time for our Winter Overnight at Birchwood Camp! All 5th and 6th graders are invited to spend the night at Birchwood Camp with Saint John United Methodist Church!

Join us for a faith fill retreat that is based on building community and Christian love! Please fill out the form below or contact the St. John office at (907) 344-3025 for more info.

 

Friday, February 2nd – Saturday, February 3rd 
Meet at St. John UMC at 9:30 a.m. on Saturday, February 2nd to depart for Birchwood. Pick Up will be at St. John UMC at 11:15 a.m. on Saturday, February 3rd, We will spend the night in the cabins at Birchwood Camp. We will have a Camp Fire, make S’mores, play capture the flag in the dark, and worship outside on Saturday. There will be plenty of time to sled/ if there’s snow, ice skate, and enjoy being outside. If being outside is not your thing, then bring a game or a book and settle into the main cabin for a relaxing time. Cost is $65.00 (payable via EasyTithe) per person this covers 4 meals, all snacks, and lodging.  Scholarships are available. Chaperones are needed, welcome, and free. Friends are welcome Turn in your registration form in the church office, or contact Erynne DeVore at 344-3025, children.sjumc@gmail.com if you have any questions.

Packing List

  • Bible

  • Sleeping bag

  • Pillow

  • Flashlight/headlamp

  • Winter gear (helmet - for sledding, snow boots, snow pants, warm coat, hat, gloves)

  • Extra Socks (just in case yours get wet)

  • Recreational gear (sleds/ if there’s snow, ice skates)

  • Personal toiletries and clothing (including pajamas) 

  • Board Games and crafts (optional)

  • NO electronics or food (please and thank you)

  • Great attitude :)

Child's Name *
Child's Name
Birthdate *
Birthdate
Gender *
Address
Address
Parent/Guardian Name *
Parent/Guardian Name
Primary Phone Number *
Primary Phone Number
Secondary Phone Number *
Secondary Phone Number
Additional Parent/Guardian Name *
Additional Parent/Guardian Name
or other Emergency Contact
Primary Phone Number *
Primary Phone Number
Secondary Phone Number *
Secondary Phone Number
Full Name of Insured
Full Name of Insured
Check Box Below to Agree to Media Release *
I, Parent/Legal Guardian of (child’s name listed above), hereby grants permission to St. John UMC, its agents and assigns, to use above named child’s photo or video, and likeness for the purpose of promotion by St. John UMC for all forms, media and manners, for the following, but not limited to, news releases, photographs, video, audio, website/social media, marketing, advertising, trade, promotion, exhibition for an indefinite period of time. I give unrestricted permission for images, videos, and recordings of the child to be used in print, video, digital and internet media. I agree that these images and/or voice recordings may be used for a variety of purposes and that these images may be used without further notifying me. I further acknowledge that I will not be compensated for these uses and that St. John UMC owns all rights to the images, videos, and recordings, and to any derivative works created from them. I waive any right to inspect the uses of any printed or electronic copy. I hereby release St. John UMC and its agents and assigns from any claims that may arise from these uses, including without limitation claims of defamation or invasion of privacy, or of infringement of moral rights or rights of publicity or copyright. This Release expresses the complete understanding of the parties.
Check Box Below to Agree to Code of Conduct *
Code of Conduct As the parent/legal guardian of this registered youth, I agree on our behalf: To abide by the Covenant of Conduct In all meetings, retreats, or other events under the sponsorship and/or guidance of my church, I am a representative of that Christian community and I am responsible for my actions. St. John Leadership/Birchwood has my/our permission to attend and participate in the 2019 M&M Winter Retreat at Birchwood Camp. Please seek any medical assistance while this child is with St. John United Methodist Church. We hereby grant permission to St. John UMC, its agents and assigns, to use above named youth’s photo or video, and likeness for the purpose of promotion by St. John UMC for all forms, media and manners, for the following, but not limited to, news releases, photographs, video, audio, website/social media, marketing, advertising, trade, promotion, exhibition for an indefinite period of time. I give unrestricted permission for images, videos, and recordings of the child to be used in print, video, digital and internet media. I further acknowledge that I will not be compensated for these uses and that St. John UMC owns all rights to the images, videos, and recordings, and to any derivative works created from them. I waive any right to inspect the uses of any printed or electronic copy. I hereby release St. John UMC and its agents and assigns from any claims that may arise from these uses, including without limitation claims of defamation or invasion of privacy, or of infringement of moral rights or rights of publicity or copyright. This Release expresses the complete understanding of the parties. I/We have read and understand the above document. By signing this document I/We hereby release St. John United Methodist Church, from any and all liability for personal injury or damage to property.
Myself and my child understand that they will be abide by the Responsibilities and Guidelines established by Birchwood Camp, and St. John United Methodist Church. *
Please check one
Date Signed *
Date Signed