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Lord of the Rings Lock-In
What: Lord of the Rings Marathon and Lock-In
When: Friday, April 12, 2019 from 9 p.m. to 9 a.m.
Where: St. Timothy's Episcopal Church (630 Mississippi Ave)
Who: High Schoolers
Cost: $5 per person for pizza
Parent Name
Parent Phone Number
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Parent Email
Additional Parent Name
Additional Parent Phone Number
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Additional Parent Email
I understand that I will need to fill out a paper release for before my youth is able to participate in the lock-in.
Yes
No
Information for Student #1
Student Name
First
Last
Gender
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Male
Female
Birthday
MM
/
DD
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YYYY
Grade (2018-2019 school year)
Please select
6th
7th
8th
9th
10th
11th
12th
Adult Chaperone
Student Email
Student Phone
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Does the participant have any allergies, physical limitations, dietary restrictions, etc that Elizabeth and the other adult leadership should be aware of during the retreat?
Information for Student #2
Student Name
First
Last
Gender
Please select
Male
Female
Birthday
MM
/
DD
/
YYYY
Grade (2018-2019 school year)
Please select
6th
7th
8th
9th
10th
11th
12th
Adult Chaperone
Student Email
Student Phone
###
-
###
-
####
Does the participant have any allergies, physical limitations, dietary restrictions, etc. that Elizabeth and the other adult leadership should be aware of during the retreat?
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