2024 JCHYK Retreat Registration

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F.E.A.R - Face Everything And Rise

Embrace fear to unleash one's full potential - Discourses, Workshops, Games and Activities

Retreat timings (EST):

Friday, May 17 : 6:30 PM - 9:30 PM
Saturday, May 18 : 8:00 AM - 10:30 PM
Sunday, May 19 : 8:00 AM - 2:00 PM

Location: Chinmaya Saraswati Ashram, Orange, CT 06477

For 8th grade to 12th grade students

Early Registration: $150.00 per student by Sunday, April 21

Regular Registration: $175.00 per student

Questions? Vidya (203) 521-6626 or Usha - (203) 435-8100

Youth First Name *

Youth Last Name *

Youth email address *

Youth phone number *

Grade of Youth as of September 2023 *

Please list any food allergies *

Please list any dietary restriction. *

Please list any environmental, non-food allergies like pollen, insects etc. *

I hereby, give permission to Retreat coordinators to take pictures, videos or audios, of my minor (youth) while participating in activities during the Retreat. Please enter your full name as a signature. *

Number of adults attending the Retreat with the youth *

Name of all adults attending the Retreat (Provide Full names and use comma between the names) *

Phone numbers of all the adults attending the Retreat (Use commas between the phone numbers. These will be added to a group chat to communicate the details before and during the event). *

In the event of any emergency, I authorize the CMFN JChyk Retreat Coordinators to bring my minor to the closest medical facility for immediate care and agree that I will be responsible for payment of any and all medical services rendered. I understand that this authorization includes transporting my child by ambulance if necessary to the nearest medical treatment facility if I am unable to be reached first. Please type in your full name as a signature. *

Please provide emergency contact name, relation and phone number. *

Please make a payment of $150/- per youth (by April 21) or $175/- (after April 21) using the link provided - https://tinyurl.com/2fdfdxjz I have made the payment. *

Yes

Required

I understand that no fees can be refunded in case of withdrawal from the Retreat at any time.
*

Yes

Required

Please email us at cmfnseva@gmail.com if you have any questions.

Thanks, Sevaks, CMFN

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