MIDD UCC Women's Retreat

Thank you for registering for the Midd UCC Women's Retreat at Silver Bay YMCA, May 8-9, 2026. We are looking forward to the time together to exhale, refresh and reconnect with our church community. The retreat will officially begin at dinner on Friday (5:30pm) and conclude Saturday afternoon around 5pm but you are welcome to arrive early on Friday to enjoy the beautiful campus and the activities available. All rooms will be in the Inn and have their own bathrooms.
The program schedule will be coming. This is to secure a room for yourself and any others that you wish to lodge with. For any other questions, reach out to may@midducc.org.

Name

This address will receive a confirmation email

Phone

Lodging Options - Please note we will do our best to provide your room preference but we cannot guarantee. Thank you for understanding.

If you chose to share a room:

Name(s) of people you wish to room with.

Please provide any special lodging requirements or dietary restrictions.

Attendee 1 Meal options

Attendee 2 Meal options

Attendee 3 Meal options

Waivers

PLEASE REVIEW THIS “GENERAL RELEASE AND COVENANT NOT TO SUE” AND CONFIRM YOUR UNDERSTANDING OF ITS CONTENTS. YOUR AGREEMENT TO BE BOUND BY ITS TERMS IS A CONDITION OF YOUR PARTICIPATION IN THE RETREAT AND ACTIVITIES.

I certify and affirm that I have been fully informed that by participating in the MiddUCC Women's RETREAT, I (my family) will participate in certain activities that involve inherent risks and potential dangers. I understand that this Authorization, Consent, and Release remains in effect regardless of whether the activities are provided free of charge or for a fee. I voluntarily assume all risks associated with participation for myself (and my family), including any harm, injury, or damages that may occur, whether known or unknown, foreseen or unforeseen. I still choose to participate. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless the staff and volunteers of Middlebury Congregational Church from any and all claims, demands, or causes of action connected to my (and my family’s) participation in camp activities. I understand that I am responsible for informing the staff of any health considerations or medical conditions that may limit my (family’s) ability to safely participate in any activities. In the event of an emergency, I authorize the examination and/or treatment by a licensed physician or other licensed health care provider in the United States, as deemed necessary. I give permission for any medical professional to provide any and all treatment considered appropriate in their professional judgment. I agree to be financially responsible for all medical expenses incurred as a result of this authorization. I acknowledge that by signing this document, I may be waiving the right to bring legal action against the church if I am (my family is) injured or property is damaged during participation. I agree that if any part of this agreement is found to be invalid or unenforceable, the remainder shall continue in full force and effect. I confirm that I have read and understood the contents of this Authorization, Consent, and Release prior to signing. Signature and date

Congregational Church MEDIA RELEASE FORM

Please read the following statement carefully: I irrevocably consent to and authorize the Congregational Church of Middlebury, UCC (MiddUCC) to use, reproduce, and publish—in any medium—all forms of media content captured during retreat activities, including photographs, video recordings, and audio recordings, as specified below. I further authorize MiddUCC to use my name or, if I choose, a fictitious name, in connection with the above media. I acknowledge that MiddUCC retains the right to edit, copyright, and distribute these materials for lawful promotional, educational, or informational purposes, without compensation to me. I understand and expect that MIddUCC will make reasonable efforts to contact me should the use of my image, voice, or performance be proposed for purposes beyond those outlined below. Types of Media Use: Middlebury Congregational Church website (e.g., event highlights, galleries, blog posts) Church’s social media (e.g., Facebook, Instagram, YouTube) Printed promotional materials (e.g., flyers, brochures, newsletters) Church bulletins or presentations.

Media Release

I consent to any media use by the Church I do not consent to any media use (no photos, videos, or recordings).

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

MIDD UCC Women's Retreat

Description

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