Spread Hope Retreat – Never Forgotten 77

Hope. Love. Support. Food. Fun.

Please join us in the up coming year. The date’s for 2024 for the retreat are August 16th – 18th.

Spread Hope Retreat Registration

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State Zip

Phone(Required)

Email(Required)

Enter Email Confirm Email

Please Select One(Required)

Adult/Parent

Volunteer

Student (please fill out student information)

Student Information

Student Age

School Grade Completed

Student's Date of Birth

Emergency Contact Information

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Medical Profile

Health issues we need to be aware of

(Asthma, Sinusitis, Bronchitis, Diabetes, Upset Stomach, Ulcer, Dizziness, Kidney trouble, Heart trouble, etc.)

Allergies

Food, medicine, or any other substance

Special dietary needs or concerns

Family Physician or Provider(Required)

Physician or Provider Phone(Required)

Permissions

Please initial(Required)

My permission is granted for Camp Survivor (Neverforgoten77/Drew’s Decision’s/Lion’s Camp) executive directors, event directors, camp First Aid Coordinator, or sponsor with whom my child came, to obtain necessary medical attention in case of sickness or injury to my child. I do hereby consent to allow transportation to a proper medical facility if required by a medical emergency. I do hereby consent for all medical care prescribed by a duty licensed Doctor of Medicine for my child.

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I also understand that as a participant of this camp, my child may be photographed and/or videotaped during normal camp activities and events and that such media may be used in promotional materials.

Please initial(Required)

Finally, I, the undersigned, do hereby verify that the above information is correct, and I do hereby release Camp Survivor and its directors, camp sponsors, or state conventions, and their employees from any and all claims, demands, actions, or causes of action, suits, and liabilities out of attending this camp or while on Lions Camp Property.

Please complete and sign below

Digital Signature (required)(Required)

(participant under 18 years of age requires parent/guardian signature)

Date of signature(Required)

Email	info@neverforgotten77.org
Address	1725 S. Jackson St. Casper, WY 82601
Phone	(307) 337-7763