H2O Retreat | Registration Form & Information

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H2O Kehukee Retreat Registration & Medical Release

H2O Kehukee Retreat Registration & Medical Release

Please see Retreat Info & FAQ for more information. Strict registration deadline (with payment) is August 16, 2020.

Family Information

This will be used to send a copy of this registration form, and other important trip updates

Trip Information

Total cost $50.
If paying by credit card, use your MPBC App or pay on our website (this link will be in your confirmation email)
If paying by cash/check, put in envelope in Black Box by church office door.
More than one request can be added, but only the first one will be guaranteed
Do you have a 2020 Medical/Travel release on file? *

Medical Release Information

If you choose one, a text box for more information will appear.

Medical & Travel Release

The paper Registration and Medical Release form will be created with the information on this digital form. It will need to be signed by a parent or guardian at retreat check in.

The following release will be included:
"My permission is granted for any Mount Pleasant Baptist Church staff member or sponsor in charge of the H2O Retreat to obtain medical attention in case of sickness or injury for (child's name).

"I/We, the undersigned, do hereby release, remise and forever discharge all sponsors and Mount Pleasant Baptist Church, Colonial Heights, Virginia, from any and all claims, demands, actions, or cause of action, past, present, or future arising out of any damage or injury while participating in this event. I also agree to pick up my student or reimburse MPBC for the cost of sending my student home in the event that he/she commits any infraction of the rules, puts their fellow participants in danger, or exhibits a disruptive attitude."


Location:Camp Kehukee

Days: September 3-5

Time:Meet at church at 4:30 pm; pickup kids at Camp Kehukee at 5:30 pm on Saturday (family cookout & awards presentation)

Where to meet:Mount Pleasant Baptist Church


  • Register by August 16: $50/child

Theme: Camp Out: Discovering a Hunger for Jesus


  1. What is included in the cost? 3 days/2 nights of lodging, meals, retreat t-shirt, and activities.
  2. May my child bring a friend? Yes! Your child may bring as many friends as they want but they must also register by the deadline.
  3. How do I register? Go to mpbclife.com/H2O(scroll to the bottom of the page and look for the H2O Retreat Registration Form), or by picking up a paper form at the Elementary Welcome Desk.
  4. How do I pay?You can pay on the website, kiosk, app, cash, or check.
  5. Will there be a packing list?Yes, we will provide a list when the date gets closer.
  6. What will my child be doing during this retreat?Your child will have at least 1 chapel session a day, go swimming (weather depending), play plenty of games, activities on the lake, group competitions, small group discussions, personal quiet time with the Lord, and much more!
  7. When is the deadline to register? August 16th
  8. May my child request a roommate?If your child is bringing a friend with them, they may request to share a room with them. You will find this request on your registration form. There are 4 kids to a room.
  9. May my child bring their cell phone?We do not recommend your child brings their phone, but if they do, it will be collected at camp. If your child needs to contact you, they can see their counselor to get their phone back for a few minutes or use their counselors’ phone. You will receive a list of our counselor’s phone numbers when you drop off your child.


Still have questions? Contact Pastor Garrett at garrett.oppel@mpbclife.comor call/text him at 804-898-8795.



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