Registration Form

PLEASE NOTE: If you are registering multiple students you will need to complete separate Parent/Student Questionnaire forms for each. Questions must be answered by a parent or guardian for students under 18. This information will be kept confidential.

I am 18 years old or older. *Skip parent / guardian info.
YesNo

I am 17 years old or younger. *Please have your parent or guardian complete this form.
YesNo

How concerned are you about the possible transmission of COVID-19 at this retreat?

Add a personal note detailing any special concerns you might have:

I promise to inform ReThink315 if I am (or my student is) exposed to COVID-19 or if I (or my student) exhibit any COVID-19 symptoms within 10 days of this event.
Yes

Initial here:

NOTE: If you checked "extremely concerned" you may want to think and pray about skipping this event. Our leaders and the venue workers will be honoring all local CDC guidelines for indoor / outdoor public gatherings and meal services. However, students will have an appropriate amount of "personal liberty" during their stay. While indoors, we will group and separate students according to their comfort levels and will, to the best of our ability, take every precaution to ensure everyone's safety.

Parent/Guardian Information

Parent or Guardian's First Name

Parent or Guardian's Last Name.

Parent or Guardian's Phone

Parent or Guardian's E-mail.

Retype E-mail:

Parent Street Address

Parent City

Parent State

Parent Zip Code

Home Church (*)

Student Information

Student's First Name (*)

Student's Last Name (*)

Student E-mail (*)

Retype E-mail (*)

Student Cell Phone (*)

Student Gender (*)

Student Birth Date (*)

Student Street Address

Student City

Student State

Student Zip Code

Is attending student a professing Christian?
NOTE: Our retreat is geared toward professing Christian teens. (*)

Does attending student make friends easily?
(NOTE: If "no" our staff will work discretely to help your student make friends and feel welcome.) (*)

If your student wishes to room with a particular friend, please name them. (All rooms have a capacity of 2 students.)

Student Medical Information

Emergency Contact Name / Phone (*)

Does attending student have any medical problems, dietary restrictions, or known allergies we should know about? (*)

If "yes" please explain:

List all medications camper will bring to retreat. Type? Dosage? Frequency? Purpose?

(NOTE: All medications must come in the ORIGINAL LABELED CONTAINERS and must be checked in with ReThink315 staff.)

Is your student able to administer their own medications?

If "no" please explain.

Parent Night Presentation

Will you be attending our parent night presentation on Monday, June 27 at 6PM? (*)

Will you be bringing guests? (You may bring up to 1 guest.) (*)

Liability, Medical, and Audio/Video Information

Download our Waiver here.

By entering my initials below I am acknowledging that I have read and agree to the terms of the Liability, Medical, and Audio/Video Waivers. (*)

Date (*)

Help Us Reach More Students

Tell us how you heard about us. (*)

Would you be willing to forward an electronic retreat flyer to friends and family? (*)

If "yes" we will email you an electronic flyer with recommended email language.

Will you commit to pray for ReThink315 students & staff? You will receive one prayer email per month. (*)

Payment Information

How will you be paying your tuition for this student retreat?(*)
I am paying by check.I am paying online.

OPTION 1: To pay tuition by check, please mail your check to:

ReThink315
P.O. BOX 494
Wentzville, MO 63385
Make payable to: ReThink315

OPTION 2: To pay student tuition by credit card, click the button below:

Pay Tuition Here!

Total retreat tuition is $300 per student, except where discounts or scholarships are applied.

NOTE: Payment is due on or before June 1 unless other arrangements are made.
Email our Director, Jeremy Smith at jsmith@ReThink315.com to make special arrangements.

Do you have a $50 off discount code?(*) Write the code in below and deduct $50 from your check.

Type in discount code here:

Would you like to help sponsor a student less fortunate than yours.(*)

If "yes", send a separate check for any amount and write "student sponsorship" in the memo line. Sponsorships are tax deductible.

Almost Finished!

After submitting this form, you will receive a registration confirmation email along with links to Frequently Asked Questions, Retreat Rules, Covid-19 Precautions, Copies of the Waivers, and a Supply List. If you do not receive that email please check your spam folder first then contact our Director, Jeremy Smith, at 314-803-8800 or jsmith@ReThink315.com.