This document provides information about an upcoming fall retreat for junior and senior high students hosted by Berean Baptist Church and Epic Student Ministries. The retreat will take place from October 20-23, 2011 at Lake Beauty Bible Camp in Long Prairie, Minnesota. The retreat will include various outdoor adventure activities such as paintball, polar bear dip, climbing tower, ziplining, and horseback riding. The document provides packing lists, permission forms, registration deadlines, costs and payment information for attendees.

1. Paintball*
Polar Bear Dip
Night Games
Low Ropes
Climbing Tower
Chapel
Football
High Ropes
Challenge Course
Horseback Riding*
Zipline
Bring All Your Adventure
Seeking Buddies
* Additional permission signature and $10 fee required.
Fall
RetreatOCTOBER 20-23 2011
Junior & Senior High
Berean Baptist Church
309 E Co Rd 42, Burnsville, MN 55306
Youth Office 952.223.1847
www.epicSM.com
Emergency Camp Phone Number
320.732.3218
ITEMS TO PACK
Bring money for dinner on the way to camp
J Warm bedding (and pillow)
J Warm clothes and jacket
J Old clothes
J Long pants
J Two pairs of shoes (one old pair)
J Flashlight
J No electronics allowed
J Toiletries
J Bible
J Notebook
J Pen
J Swimsuit
J Towel

2. Fall Retreat 2011
Permission Release
NAME ___________________________________________________
ADDRESS ________________________________________________
CITY _____________________ STATE ________ ZIP ______________
PHONE (__________) ____________-______________ GRADE ______
VISITOR? KYES KNO IF YES, BROUGHT BY ___________________
T-SHIRT SIZE KS KM KL KXL
I give permission for my child to join Epic Student Ministries of Berean Baptist Church
on the EPIC FALL RETREAT `11 Weekend at Lake Beauty Bible Camp from Oct. 20- 23.
I understand that the group will be traveling by buses and 15-passenger vans. I also
understand the cost includes food, transportation, and all programming.
I agree that the staff member or adult in charge is authorized to solicit medical care in
the best interest of my child in case of an emergency arising during the course of said
minor’s attendance at the aforesaid function. I further understand and agree that my
medical insurance coverage or other applicable insurance coverage, if any, are primary
coverage for the protection of the child and that any insurance coverage provided by
Berean Baptist Church are secondary coverage.
All participants must also have a “Berean Baptist Medical Consent” form on file at the
church office. They can be found on-line at www.epicsm.com. If you are unsure as to
how to answer any of the questions, please contact us at 952.223.1847.
1. The church has a completed copy of the Berean Baptist
Church Medical Consent form, signed by me (parent/legal
guardian), on file for this current school year.
2. All health and insurance information (regarding question #1)
is accurate and up-to-date.
3. All emergency phone numbers and medical information
(regarding question #1) are up-to-date.
4. I give my consent to use pictures or video of my student
on the Berean website or for event promotion.
Signature _________________________________________________
(PARENT OR LEGAL GUARDIAN)
DATE ________/________/________
EMERGENCY PHONE NO. (__________) ____________-______________
PAID: KCASH KCHECK* (# ____________ AMT. _______________)
KCREDIT VOUCHER (AMT. ___________________)
*MAKE CHECKS PAYABLE TO BEREAN BAPTIST CHURCH
———————————————————————————————
Lake Beauty Bible Camp Horse Trail Ride Permission/Release Form
Camper Name (please print):_________________________________________
Horseback Trail Rides: I hereby give permission, as indicated by my signature below,
for my child (the camper named above) to participate in Lake Beauty’s trail rides. I
understand that signing below does not register my child for trail rides; rather, it gives
permission for them to participate. I also understand that campers participating in
horseback riding activities will be given introductory safety instructions before going
on trail rides and that all riders will be required to wear protective head gear which the
camp provides. It is my understanding that camp personnel seek to ensure a safe,
educational, and fun program.
Signature _________________________________________________
(PARENT OR LEGAL GUARDIAN)
DATE ________/________/________
KYES KNO
KYES KNO
KYES KNO
KYES KNO
Cost: $180, plus $5-10 cash for dinner on
the ride up to camp. Includes transportation,
program & meals at camp.
Registration Deadline: Oct 12, 2011
Scholarship forms available online at
www.bereanbaptist.com/events
Speaker
Cesar
Castillejos
CUTOFFANDRETURN
Fall
RETREAT
CastillejosRETREAT
RETREAT
EPIC
Thursday, Oct 20 - Sunday, Oct 23
Adventure Destination:
Lake Beauty Bible Camp
Long Prairie, MN 56347-9734
Phone 320.732.3218
www.lbbc.com
Drop Off: At Berean ~ Thursday, Oct. 20 at 2:30
Pick Up: At Berean ~ Sunday, Oct. 23 at 2:30
Both at Berean’s Main Entrance
Cost:
the best interest of my child in case of an emergency arising during the course of said
minor’s attendance at the aforesaid function. I further understand and agree that my
medical insurance coverage or other applicable insurance coverage, if any, are primary
coverage for the protection of the child and that any insurance coverage provided by
Berean Baptist Church are secondary coverage.
All participants must also have a “Berean Baptist Medical Consent” form on file at the
church office. They can be found on-line at www.epicsm.com. If you are unsure as to
how to answer any of the questions, please contact us at 952.223.1847.
Signature _________________________________________________
DATE ________/________/________
EMERGENCY PHONE NO. (__________) ____________-______________
PAID:
KYES
KYES
KYES
KYES
CUTOFFANDRETURN