2025 Winter Retreat Youth Camp Registration-Student

12/26-12/29/2025 | Please fill out this form and click submit. You must pay in order for your registration to be "effective". After 12/13, you are unlikely to get a T-shirt.

Please ensure that you use the exact same name for both registration and the waiver form. Fail to complete the waiver form would potentially invalidate your registration.
 
 
 
 
 
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Parent/Guardian and Medical Insurance Information:

 
 
 
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In order for the Group to expedite treatment for any unforeseen emergency, please provide the student's medical insurance information below. The Group will keep the information confidential.
 
 
 
Special Concerns or Needs:

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If you have food allergies or dietary restrictions, please complete the following 2025 Food Allergies and Dietary Restrictions Form.

After you click the link below, a new window will open for you to complete the dietary restriction form. Then you can return to the registration form tab to continue your registration process.


2025 Food Allergies and Dietary Restrictions

 
Waiver and Consent:

Please complete the Shocco Waiver & Release Form in the link below.

After you click the link below, a new window will open for you to complete the waiver. Then you can return to the registration form tab to continue your registration process.


The "Event Name" for the waiver form is "2025 Atlanta Chinese Christian Church North Youth".


2025 Shocco Youth Retreat Waiver

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Assumption of Risks and Waiver of Liabilities Relating to COVID-19 and Other Infectious Diseases


The Atlanta Chinese Christian Church (“the Church”) has put into place preventative measures to reduce the spread of COVID-19 and other infectious diseases; however, the Church cannot guarantee that you or your child or children or other family members will not become infected with viruses. Further, attending the Church or participating in any of its sponsored activities could increase your risks and your family member’s risk of viruses.

By checking the box below, I acknowledge the contagious nature of COVID-19 and other infectious viruses voluntarily assume the risk that my children or I may be exposed to or infected by viruses by participating in Church congregational worship or other church sponsored  or approved activities and that such exposure or infection may result in personal injury,  illness, permanent disability and death. I understand that the risk of becoming exposed  to or infected by COVID-19 and other viruses through the Church’s sponsored activities may result from the actions, omissions, or negligence of myself and others, including but not limited to, Church employees, volunteers, and program participants and their families and guests.


I voluntarily agree to assume all the forgoing risks and accept sole responsibility for any injury to my children or myself (including, but not limited to, personal injury,  disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my children may experience or incur in connection with my or my children’s  attendance at the Church or participation in the Church’s programing (“Claims”). On my behalf and on behalf of my children, I hereby release, covenant not to sue,  discharge,  and hold harmless the Church, its employees, agents, and representatives and governing bodies and members of such bodies from the Claims, including all liabilities,  claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.  I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Church, its employees, agents, and representatives, whether a COVID-19 or other virus infection occurs before, during, or after participation in any Church program.

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Payment and Cancellation Policy:

Cancellations accepted until 12/10/2025 without charge.

Cancellations after 12/10/2025, a $40 fee will be applied.

No cancellations will be accepted after 12/14/2025 and no refunds will be issued.

Cancellation requests must be made in writing and submit to youth@acccn.org. In your message, please include:

Name of youth

Name of church
You will be redicted to a PayPal page to complete the payment.
$260.00
 

Description

12/26-12/29/2025
Please fill out this form and click submit. You must pay in order for your registration to be "effective". After 12/13, you are unlikely to get a T-shirt.

Please ensure that you use the exact same name for both registration and the waiver form. Fail to complete the waiver form would potentially invalidate your registration.