2022 All Stars | Winter Retreat Registration

We invite you to 2022 AS Winter Retreat!
Please fill out this form ONE per student. If there are siblings, please fill out another form.

The retreat will be December 17 (Saturday) - December 19 (Monday) at Sandy Cove. We're so excited you're here and can't wait to worship together this retreat! If you have any questions, feel free to shoot an email to allstars@kcpc.org.

*If you are a PK or MK, email allstars@kcpc.org for a separate form.

**If you will be paying by check or if you want funds from winter retreat applied to this retreat, please fill out the form below instead:
https://kcpc.breezechms.com/form/redeemed-chk
Instructions for the checks will be in the form.

Student Full Name (학생 이름)

Student Cell Phone

Student Email

Grade (학년)

Does the student attend KCPC? Yes No

Parent 1/Guardian Name (부모 1/ 보호자 이름)

Parent 1 Phone (부모 1 전화번호)

Parent Email (부모 이메일)

This address will receive a confirmation email

Parent 2 부모 2 이름 ("n/a" if not applicable)

Parent 2 Phone 부모 2 전화번호 ("n/a" if not applicable)

Emergency Contact (긴급 연락처)

Emergency Contact Name (이름)

Relation to Student 학생과의 관계 (e.g., grandmother, aunt)

Emergency Contact Phone (긴급 연락처 전화번호)

COVID-19 Guidelines

To ensure the safety of our students, we will be taking the follow precautions:

1) Everyone, including students and leaders, are encouraged to wear their masks during the retreat.
2) We are encouraging our students and leaders to be vaccinated before attending the retreat.
3) If the student is not feeling well before the retreat, please stay home. This is to enure the safety of the student as well as everyone going on the retreat.

Although KCPC All Stars will be taking all the precautions listed above, KCPC All Stars is not liable for a potential COVID-19 infection from the retreat.

I have read and agree to the above statment regarding COVID-19 policy at the retreat.

I agree

Refund Policy

If you must request a refund for whatever reason after the registration, you may do so by December 4. After December 4, we cannot accept any refund request unless they are COVID-19 related. You may request a refund after December 4 only if your child cannot attend the retreat due to COVID-19.

Please write the refund request, the full name of the student, and the amount to allstars@kcpc.org.

I have read and agree to the above refund policy.

I agree

Registration Fee (등록비)

If you will be paying by check, or if you would like to apply the funds from winter retreat to this retreat, please fill out this form:
https://kcpc.breezechms.com/form/redeemed-chk

Instructions for the checks will be in the form.

Payment $120

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Please fill out this form and click submit.

2022 All Stars | Winter Retreat Registration

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