Student Fall Retreats 2019

Which camp are you attending?

Name

Address

Phone

This address will receive a confirmation email

First Parent/guardian's name

Second parent/guardian's name

Emergency contact number

Medicines/special concerns?

This next "ropes course"question applies only if you are registering for The Lou Connect Middle School Fall Retreat.

I want to go on the high ropes course! Yes No

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

The Lou Connect
Middle School Fall Retreat
October 18th-20th
Logan Valley Christian Retreat Center
Cost: $115

The Lou Serve
High School Fall Retreat
November 8th-10th
Downtown St. Louis
Cost: $100

Student Fall Retreats 2019

Description

Please Fix the Following