Life in Jesus Retreat

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1 Life in Jesus Retreat Fri-Sun. October 28-30, 2011 For: 5 th -9 th grades Retreat Leader: Pastor Alan Klatt (pastork@northpointlife.org) cell Location: Camp Whitcomb/Mason Merton, WI Awesome Activities: Campfire, outdoor team building, volleyball, basketball, soccer, games, Bible time*, worship, music, fun!! Total Cost: $79 per person (two night chaperoned stay in a camp lodge, expert guided team challenge course**, meals, retreat booklet and T-shirt included) Registration Deadline: Tuesday, October 18, 2011 payment must accompany registration sheets [Make checks to NorthPoint Community Church and mail to Rev. Alan Klatt - c/o Register LIJ Retreat - W282N7388 Main St. - Hartland, WI 53029] *Our topic is Joseph Prince of Egypt relating his experiences to everyday challenges in light of our life in Jesus Christ. Application includes dealing with fears, peer pressure, bullies, character challenges and trust in God. **We will utilize the professional camp staff for this 3-hour activity on Saturday which involves team building using low elements of a ropes and challenge course up to 5 feet off the ground. Cost included in retreat registration ($17 per participant).

2 Life In Jesus Fall Retreat 2011 Camp Whitcomb/Mason--Stiemke Lodge Friday 5:00 p.m. Retreat Counselors Meet at Stiemke Lodge 5:30 p.m. Retreat Attenders Arrive, Sign In 6:00 p.m. Retreat Orientation 6:30 p.m. Community Builders 7:15 p.m. Session 1 Want to Be Joseph? (Pastor Klatt) 8:00 p.m. Snack and Video: Joseph Prince of Egypt 10:00 p.m. Cabin Devotions/Lights Out Saturday 8:00 a.m. Breakfast 8:30 a.m. Sealed Orders 9:00 a.m. Team Building (Steve Camp Whitcomb Staff) 12 noon Lunch & Break 1:00 p.m. Session 2 Fear, Pressure and Trust (Pastor Klatt) 2:30 p.m. Break/Free Time 3:00 p.m. Games and Activities 5:00 p.m. Supper 6:00 p.m. Session 3 Joseph with God 7:00 p.m. Snack/Worship Preparation 8:00 p.m. Worship Service (campfire) 10:00 p.m. Cabin Devotions/Lights Out Sunday 8:30 a.m. Breakfast 9:00 a.m. Sealed Orders What to Bring Sleeping Bag Pillow Toiletries Towel Bible Pen/Pencil Appropriate clothing to season 9:30 a.m. Session 4 Living out Loud (Pastor Klatt) 10:30 a.m. Clean Up & Pack 11:30 a.m. Depart

3 NorthPoint Community Church Permission Form In order to best preserve the health and safety of your child, please provide permission for your child to participate in this activity. Thank You. I request my child,,be allowed to participate in the LIJ Retreat at Camp Whitcomb/Mason, WI, October 28-30, I understand that they will be participating in all activities associated with the event. I understand that all reasonable precautions will be taken by NorthPoint staff to avoid injury to my child and to provide for their well-being during this event. In consideration thereof, I waive any claims for damages and/or injuries that may arise from or may be incident to the activity described above to the extent allowed by the law. I further understand that NorthPoint and its staff may not be held responsible for the intentional or negligent acts of other persons who are not on its staff. I give consent to any medical care or treatment which may be deemed necessary including taking my child to a doctor or hospital and giving medical treatment, including but not limited to emergency surgery or medical treatment and assume the responsibility of all medical bills, if any.i understand that, should medical attention be required, all attempts will be made to call and notify me of the situation. Thank you for providing the following up-to-date information: Student Name: Date of Birth Grade Street Address: City Zip T-Shirt Size (adult sizes): S M L XL Special Requests: Parent/Guardian Info: Name Phone: Relationship to Child: Parent/Guardian Info: Name Phone: Relationship to Child: Two Emergency Contacts (if parent cannot be reached) names/numbers: Insurance Company none Policy ID # Medications Allergies Physician s Name and Number Signature of parent/guardian: Date

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