His Legacy Retreat - Occupy Campus Ministry

Medical Release Form

Packing List & Announcememts

The 4th Annual Occupy retreat hosted by Dwelling Point Church will be held at an undisclosed location in St. Robert, Mo. This retreat brings together college students and young adults from all across the midwest region for one explosive encounter.

Name*

E-mail Address*

Telephone*

Student Id or M Number (Please put N/A if not applicable).*

Will you be staying in a tent?*

Would you like for us to arrange your transportation?*

Are you a vegetarian? *

What day will you be arriving?*

Will you be staying the whole retreat?*

Departure day (If leaving early).

Please list any special food allergies or preferences.