Permission Slip for
Chapel In The Hills
Youth Retreat
Oct 18th - 20th

YMCA of the Rockies
2515 Tunnel Road
Estes Park, CO 80511

The cost of this event is $75.00. After submitting this form you will be redirected to the registration/payment page. It is also available on the Chapel Calendar for this event.

*You must register/make payment in order to attend this event.

The Church is assisting in the financial cost of this event. If you would like to contribute more and help cover the additional cost please utilize Chapel In The Hills online giving and select the fund "Youth Retreat". Thank you!

Student Information


Parent/Guardian Emergency Contact


Please read and sign acknowledging and giving permission for your student to attend

I, the undersigned parent/guardian, authorize permission for the above student to attend Chapel In The Hills Youth Retreat on Oct 18th-20th, 2024 at YMCA of the Rockies located at 2515 Tunnel Road Estes Park, CO 80511. As parent/guardian, I do hereby release, forever discharge and agree to hold harmless Chapel In The Hills, other church staff and adult volunteers from any and all accidental and unintended liability, personal injury, sickness or death. I assume all responsibility as a result of student’s participation in church-sponsored activities.

I give my permission for my child to be photographed. I understand these photographs will be used at the church's discretion.

Should it be necessary for my child to return home due to medical reasons, disciplinary action or otherwise, I hereby assume all costs involved. This is a binding covenant and agreement.

Submit