ReThink College Camp 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 a Parent (or Guardian.)
YesNo

I am a Student.
YesNo

Student is 18 years old or older (You can skip parent / guardian info):
YesNo

Student is 17 years old or younger (Please have your parent or guardian complete this form):
YesNo

We 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:

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

Parents' Home Church (*)

Students' Home Church (*)

Student Information

Student's First Name (*)

Student's Last Name (*)

Student E-mail (*)

Retype E-mail (*)

Student Cell Phone (*)

Student Gender (*)
-Select One-MaleFemale

Student Birth Date (*)

Is the student's address the same as the parent's address? (If "yes" skip address) -Select One-YesNo

Student Street Address

Student City

Student State

Student Zip Code

Is your attending student a professing Christian?(*)
NOTE: Our retreat is geared toward professing Christian teens.
-Select One-YesNo

Does attending student make friends easily? (*)
NOTE: We won't make this public but our staff and volunteers will subtly work to help your student meet like minded friends.
-Select One-YesNo

Is your student coming to us with any particular doubts, questions, hurts, or objections? (*)
NOTE: We won't make this public but our staff, volunteers, and speakers will subtly work to help your student unpack this.
-Select One-YesNo

If "yes" please explain:

If your student wishes to room with a particular friend, please name them.

Student Medical Information

Emergency Contact Name / Phone (*)

Does attending student have any medical problems or known allergies to medicines, plants, food, etc.? (*)
-Select One-YesNo

If "yes" please explain:

List all medications camper will bring to camp:

Is your student able to administer their own medications?
-Select One-YesNo

If "no" please explain.

Parent Night Presentation

Will you be attending our parent night presentation on Friday, July 21 at 6PM? (*)
-Select One-YesNo

Will you be bringing guests? (You may bring up to 5 guests) (*)
-Select One-YesNo

How many guests will you be bringing? (*)

Liability, Medical, and Audio/Video Information

Download our Waiver here.
NOTE: By registering for this event and initialing below you agree to all the terms and conditions in the above mentioned waiver.
Yes

I read and agree to the terms and conditions in the above mentioned waiver.

Initials (*)

Date (*)

Help Us Reach More Students

Tell us how you heard about us. (*)

Would you be willing to email few retreat flyers to interested friends and pastors?: (*)
-Select One-YesNo

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: *
-Select One-YesNo

Payment Information

Payment Method:(*)
I am paying by check.I am paying online.

Do you have a $50 off discount code?:
-Select One-YesNo

What is your discount code?

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 or debit card, click the link below after you submit this registration form:

CLICK HERE TO PAY TUITION ONLINE

NOTE: If you pay online, don't forget to come back and finish this registration page.

I would like to learn how I can help sponsor the tuition of a student less fortunate than mine.(*)
-Select One-YesNo
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. If you do not receive that email please check your spam folder first then contact our Executive Director, Jeremy Smith, at jsmith@ReThink315.com, or our Operations Director, Daniel DeFonce, at ddefonce@ReThink315.com.

Δ