2025 Winter Xtreme

The FBC Youth Ministry will be traveling to Timber-lee Christian Retreat Center in East Troy, Wisconsin for another year of fun! Camp offers tons of fun things like tubing, broom ball, tobagganing, powerful worship and great speakers. The cost is $130.00 per person. Participants will need to sign up by December 15, 2024 and have a parent/guardian complete this form to be able to attend.

Middle School Dates: January 10 - 12, 2025
High School Dates: February 14-16, 2025

Student Full Name

Gender

Birthdate MM/DD/YYYY

Middle School or High School

Youth Email

Youth Cell

Known Allergies or Other Medical Concerns

Date of Last Tetanus Shot MM/DD/YYYY

Hospital of Choice

Medical Insurance and Policy Number

Parent/Guardian's Full Name

Address

Parent's Phone

Parent's Email

Second Parent/Guardian's Full Name

Second Parent/Guardian's Phone

Second Parent/Guardian's Email

Emergency Contact (If Parent Can't Be Reached)

Emergency Contact Relationship

Emergency Contact Phone

Is FBC your home church?

If not, what church do you attend?

How did you hear about this event?

We hereby grant permission for our child to travel to Winter Xtreme in East Troy, Wisconsin. I give my permission for my child to participate in all the activities of the camp unless designated on the attached medical form. We recognize the risks and hazards of traveling and participating in winter activities and hereby release First Baptist Church of Champaign at Savoy from all liability and responsibility in regard to any incident or accident which might occur, and give the attending Youth Leaders permission to administer medical attention needed and hereby agree to indemnify and hold them harmless from any legal action which may result. We further accept responsibility for the return of all rented articles, in the same condition as when received. I agree

RELEASE: I hereby release and agree to hold harmless First Baptist Church at Savoy (FBC-CS) and designated leaders from all liability for damage, illness, or injury. In case of emergency, I give my permission for any necessary medical treatment. I will not hold FBC-CS or any leader/staff persons responsible for any injury that may occur. I also give my permission to FBC-CS to use photos of my children, without any identification, in publications and/or on their website for promotional purposes. I Agree

Parent/Guardian Electronic Signature (Type Full Name)

Payment 130.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Students are invited to a weekend away at Camp Timber Lee to connect with each other and with God! Winter Xtreme offers activities like snow tubing, tobogganing, horseback riding, amazing worship and great speakers. Cost is $130 and students should arrive to FBC to leave on their perspective Fridays by 3:30pm, the vans will leave by 4pm and return by 4pm on Sunday

2025 Winter Xtreme

Description

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