ABOUT THIS EVENT Join us this summer for an exciting retreat at Smith Mountain Lake! For students that have completed 8th-12th grades in 2025. August 1-3, 2025 $65 per person Sign-Up Parent/Guardian Name(Required) First Last Parent/Guardian Email(Required) Parent/Guardian Phone(Required)Student Name(Required) First Last Student Grade(Required)Student Age(Required)Trip Price(Required)I (the guardian) give my permission for my child(ren) to travel with representatives of Chancellor Baptist Church. I give my permission for an attending physician or hospital to administer medical care if deemed necessary by a representative of Chancellor Baptist Church, with communication with me (the guardian). I understand that there is no secondary medical coverage provided by Chancellor Baptist Church. I, therefore, do hereby release from all claims and forever hold harmless the ministers, directors, officers, members, and employees of Chancellor Baptist Church from any and all claims and demands for personal injury, sickness, and death, as well as property damage and expenses, of any nature, incurred by myself (or my child under 18 years of age). I also assume personal responsibility for all medical bills (for myself or my child under 18 years of age). Furthermore, should it be necessary for the participant to return home due to disciplinary action, for medical reason, or otherwise, I hereby assume responsibility for all transportation. I (the guardian) give Chancellor Baptist Church permission to use my child’s photograph in any and all of its publications, including websites and social media platforms.(Required) I agree to the policy as stated below:I (the guardian) give my permission for my child(ren) to travel with representatives of Chancellor Baptist Church. I give my permission for an attending physician or hospital to administer medical care if deemed necessary by a representative of Chancellor Baptist Church, with communication with me (the guardian). I understand that there is no secondary medical coverage provided by Chancellor Baptist Church. I, therefore, do hereby release from all claims and forever hold harmless the ministers, directors, officers, members, and employees of Chancellor Baptist Church from any and all claims and demands for personal injury, sickness, and death, as well as property damage and expenses, of any nature, incurred by myself (or my child under 18 years of age). I also assume personal responsibility for all medical bills (for myself or my child under 18 years of age). Furthermore, should it be necessary for the participant to return home due to disciplinary action, for medical reason, or otherwise, I hereby assume responsibility for all transportation. I (the guardian) give Chancellor Baptist Church permission to use my child’s photograph in any and all of its publications, including websites and social media platforms.Credit Card Total CommentsThis field is for validation purposes and should be left unchanged.