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I will be attending with (circle one)
Woodway Campus West Campus North Campus Pearland CampusCypress Campus
STUDENT INFORMATION:Name _____________________________________________________________________________  _________________ (First Name) (Middle Name)(Last Name)Address _____________________________________________________________________________  _________________ City _____________________________________________________ St_________ Zip________________ Home Phone # ______________________________________ Birthdate _________________________________ Student Cell # ____________________________ Cell Carrier
(Sprint, Verizon, T-Mobile, etc) ________________ 
High School ________________________________________ Grade (Next Year:Fall 2009) ___________ Gender
(Circle One)
Male Female Email Address ______________________________________________ Are you a member of Second Baptist Church? Yes or No If not,where?_____________________ 
PAYMENT OPTIONS
I am paying by: Cash___________ Check______(check #_______) Credit Card _______ 
(Please Check One)
$600 – Early Bird Full Payment Special (full payment by 4/15/09) ______ Payment in full of $600 by 4/15/09$650 – Regular Price (4/16/09 - 5/31/09) ______ $650$675 – Late Registration (after 5/31/09) ______ $675
 
Second Baptist Church High SchoolBeach Retreat 
 
CREDIT CARD INFORMATION:
(Circle One)
Visa Master Card American Express DiscoverCard Number _________________________________________________________ ExpirationDate ____________________ Name as it appears on card____________________________________________ Billing ZipCode __________________ Card Holder’s Signature _____________________ Cardholder’s Phone Number ________________________ 
Second Baptist Church – High School Ministry www.second.org
Mailing AddressCampus Contacts6400 Woodway Dr. Woodway 713-365-2494 North 713-365-6305Pearland 713-365-3479Houston, TX 77057 West 713-365-2432 Cypress 713-365-3479Office Use Only:
 
DatePmtCDT #AmtBal
 
1. Obey Adult Leaders without question or hesitation. They are in charge of you for the week.2. Wear your name tag at all times.3. Your Leader must know where you are at all times. It is your responsibility to tell your Leader whereyou will be during free time.4. Absolutely no one is allowed out of their condominium after the night’s curfew. The curfew is ineffect until 15 minutes before morning Silent Sounds.5. Students are not allowed onto the Phoenix balconies without the supervision of their leader. Inaddition, absolutely nothing is to be dropped, thrown or hung from the condominium balconies orupper level areas. Do not feed seagulls from any balcony.6. Profanity or cursing is not allowed.7. Do not associate with anyone who is not a part of our Beach Retreat group.8. Swim only when and where lifeguards are on duty. The “Buddy System” is strictly enforced. Beforeentering the ocean, you must (1) have a buddy, (2) check in at the lifeguard station, and (3) give yourname tag to a lifeguard.9. Keep your condominium clean. No raids, rough play or pranks. You are financially responsible forany damage to property, especially to a condominium or bus.10. The Phoenix has Quiet Hours beginning at 10:00 p.m. each evening. Please be courteous to otherguests staying at the condominiums by observing this time.11. Do not push, pull, or throw anyone into a pool.12. You are to be on time for all activities.13. Be positive. Cut downs, criticism, and negative comments are not allowed.
 
14.
Wear appropriate, conservative clothing. The following are not allowed: short shorts, tightclothing, skimpy tank tops, tube tops, halter tops or other revealing clothing. Girls must wearone-piece swimsuits (no tankinis).15. Be extremely cautious around traffic. NO ONE is allowed to cross the highway. This includes allfood and driver rest stops on the way to and back from Orange Beach as well as while we are inOrange Beach itself.16. Guys may not go into girls’ condos and girls may not go into guys’ condos unless your Adult Leaderis present, and it is a planned and organized activity.17. Never go anywhere by yourself. You will be allowed to visit shops and stores near thecondominiums during free time, but you must be in groups of at least three. Shuttle busses will beprovided.18.
You are not allowed to bring or purchase any of the following
: alcoholic beverages,tobacco products, firearms, knives, drugs, fireworks, electronic equipment (televisions, video games, I-Pods, cell phones, etc) balloons, balloon launchers, or inappropriate T-shirts. While on the retreat, youmay not participate in any of the following: tattooing, haircuts, hair coloring, or ear/body piercing. Your Adult Leader will inspect your luggage when we arrive at the Phoenix Condominiums.19. During your free time, you are not to be in any condo including your own, for more than 10minutes, unless your Adult Leader is present.20. Any student who sets off a fire alarm as a prank will be turned over to the police department.Upon release, the student will be sent home immediately.
 
STUDENTS WHO CAUSE PROBLEMS ON THE RETREAT WILLLOSEFREE TIME PRIVILEGES OR BE SENT HOME AT PARENTS’EXPENSE.
Student’sSignature____________________________________________________________________  _________ Parent’sSignature____________________________________________________________________  ___________ 
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