Metamorphosis Transition Retreat | Holy Trinity Episcopal Church

JDOK Diocese of Texas Metamorphosis Retreat at Camp Allen

This is a 3 day retreat for young women between the ages of 16 and 22 who are looking to deepen their relationship with Jesus.

Retreat at Camp Allen: October 9-11, 2026

Registration closes September 30th

Early Registration before August 31 - $30

Late Registration fee after August 31st - $40

First name

Last name

Email

Phone

Are you currently a member of the Junior Daughters?

Yes

No

Parent/Guardian Name

Phone Number

Email Address

Emergency Contact name & relationship

Phone Number

Name of your Church

Doctor Name (if none please put n/a)

Doctor's Number (if none please put n/a)

Insurance Company Name (if none, please put n/a)

ID/ Policy Number (if none, please put n/a)

Group ID (if none, please put n/a)

Phone number (if none, please put n/a)

Please detail any known allergies/reactions (if none, please put n/a)

List any over the counter medications NOT to give & reaction(s) (if none, please put n/a)

Please list any regularly taken prescription medications with dosage & times taken (if none, please put n/a)

List any dietary restrictions due to allergies (if none, please put n/a)

Are there any life circumstances (death, divorce or change in family circumstances, changes of school) that we should be aware of?

Are there any health conditions for which the adult staff should be aware? Does the minor have a physical, behavioral or emotional disability or have a 504 plan or IEP?

Release of Liabililty: I hereby release, relieve, indemnify & hold harmless the Junior Daughters of the King, the Daughters of the King, Camp Allen and its employees, the driver of the transport vehicle, the Episcopal Diocese of Texas and its bishops, clergy, event coordinators, youth leaders, employees, representatives and agents from any and all liablity for any injury, illness or property damage associated with my youth's participation in this activity or travel associated with this event. In the event that my child should require medical treatment and I cannot be contacted immediately, or if contacting me is not feasible because of an emergency, I hereby give consent to such treatment. The sponsors of this event do NOT provide insurance in case of injury or illness.

Please select one option

Yes

No

My child has my permission to attend and participate in the Junior Daughters of the King Retreat at Camp Allen on October 9-11, 2026 sponsored by the Daughters of the King Episcopal Diocese of Texas. I further agree my child riding in the automobile being used by my group to transport participants to/from Camp Allen. I confirm that my child is healthy and capable of participating in this event. I also confirm that my child is covered by medical insurance, or if medical insurance is not available to my child, I agree to be personally responsible for the costs of any medical treatement deemed necessary.

Please select one option

Yes

No

I understand that photos or videos of my child and others may be taken during the event, and I consent to the use of my child's photo or likeness by the Junior Daughters of the King in promotional materials. i acknowledge/confirm that the information listed on my child's application is true and accurate.

Please select one option

Yes

No

Payment options - please indicate how you would like to pay. $30 until August 31st. $40 after August 31st.

Venmo - @Vicki-Terrell-4

Paypal - @VTerrell774

Check - make check out to Holy Trinity Episcopal Church (add JDOK Metamorphosis Retreat to memo line) and mail to Holy Trinity Episcopal Church, 4613 Hwy 3, Dickinson, TX 77539