Things to bring…
o Appropriate clothes for leisure and sleep.
o Sack dinner/snacks while we wait to get in Friday
o Cold weather gear if necessary (hats, mittens,
boots, etc.)
o Personal hygiene items (toothbrush, hairbrush, etc.)
o Sleeping bag or sheet/blanket and pillow
o Air mattress (we will be sleeping on thinly carpeted floors)
o Special needs items such as medication, inhalers, etc.
o Towel (keep in mind that they don’t have showers)
Schedule…
Friday, March 10
1:00 Load up the bus at Hillcrest
1:15 Leave
3:15 Arrive at “The Bridge” & drop off stuff
3:30 Leave for Winter Jam
6:00 Doors open
7:00 Show starts
11 Show ends
Go get something to eat
12 Arrive back at The Bridge
Set-up beds, etc.
1
Night-night
Saturday, March 11
8:00 Wake up, get ready
9:00 Breakfast in the HSM youth room
10 Leave for Wood field Shopping Mall
12:30 Lunch at the food court at Wood Field
1:15 IKEA
3:30 Leave for home
5:30 Arrive back at HBC, Unload
Medical Release Form
Winter Jam
Mar. 10-11
I understand that direct supervision of my child by Hillcrest Bible Church will be limited by the nature of the activity. I
understand the risks involved, and I absolve Hillcrest Bible Church from liability to me or my child because of injury,
accident, or illness while attending the 2017 Winter Jam weekend in Chicago.
I also authorize the Hillcrest Bible Church to secure necessary emergency medical treatment for my teen in the
event of injury while on this trip.
Your child may be photographed or videotaped during this activity. These pictures/video may be used for presentation
during the conference, in our promotional materials, or on the Elevate website or social media outlets. If any media is
used online, they will not include any names. I give my permission for my child to be photographed and videotaped.
Print student’s name: _____________________________________________
Grade: _____________
Pertinent Past Medical History: _________________________________________________________
Current medications:_______________________________________Dose/Frequency_______________
Allergies __________________________________Type of Reaction_____________________________
Insurance: ___________________________________________________________________________
In case of emergency, please notify: ______________________________________________________
Print Parent/Guardian Name(s)
__________________________
Home Phone
_________________________ ___________________________
Work Phone
Cell Phone
Youth Leader’s Cell Phone Number: ______________________________________________________
I agree to all of the above & give my permission to participate in the 2017 Elevate Winter Retreat.
_______________________________________
Signature of Parent./Guardian
Form Due: Mar. 5, 2017
Payment Due: $30 by March 5, 2017
_______________________________________
Date