Date: Friday, February 14 - Sunday February 16

Time: 4:00 PM on Friday - 10:30 AM on Sunday

Location: TBD (Possibly Neptune City, NJ)

Fee: $170 per student ($160 sibling discount)

Notice: Please bring bible, journal, warm jacket/outwear, extra clothes, toiletries, and sleeping bag / air mattress

Student #1 Name

First Name

Last Name

Phone # / Parent Phone #

(###)

###

####

Student #1 Hoodie Size

Student #2 Name

First Name

Last Name

Student #3 Name

First Name

Last Name

Student #2 Hoodie Size