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Beach Retreat Youth Registration
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- Youth Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Youth Email Please enter an email address.
  
  Grade REQUIRED Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Allergies/Dietary Restrictions
  
  Medical Needs/Restrictions
  
  Note: A permission and medical waiver form will also be completed at the Beach Retreat Parent and Youth Meeting.
- Parent/Guardian Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent Email REQUIRED Please fill out this field. Please enter an email address.
- I understand that we will need to attend the Beach Retreat Parent & Youth Meeting on Wednesday, February 18, 2026 at 6pm in the Friends & Family Hall. Please select this field.
- I agree to pay the $175 non-refundable Beach Retreat fee. Please select this field.
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Contact Us
- Emily Kremer
  
  Youth Ministry Director
  
  919-942-6238
  ekremerstmchapelhill.org