Peterkin Fall 2024 Hiking Retreat • Peterkin Camp and Conference Center

Adult Full Rate: Includes Lodging Friday and Saturday Nights, Breakfast/Lunch/Dinner on Saturday, and Breakfast on Sunday 0

Peterkin Retreat Registration Form - Peterkin 2024 Fall Hiking Weekend

Welcome to Peterkin!

This registration is for Peterkin Fall 2024 Hiking Retreat, November 1st-3rd.

Attendee Information

Attendee First Name *

Attendee Last Name *

I am a Parent/Guardian in this family registration

Yes

No

Phone Number *

Attendee Email Address *

Mailing Address *

Mailing Address Line 2

Mailing City *

Mailing State *

Mailing Zip Code *

Food Allergies - Common (Dropdown - select all that apply)

Dietary Preferences *

Food allergies - Other

Other Dietary Preferences *

Peterkin will attempt to meet your dietary preferences, but if you have a very restricted diet, we recommend that you provide some of your own food.

Lodging Preferences

For those staying over, Peterkin has two primary lodging options.

Gravatt Hall has individual rooms with one to four beds, including some bunk beds, and shared bathrooms accessed from shared hallways.

The Youth Lodges have rooms containing four bunks/eight beds per room, and bathrooms within each room, along with one room per lodge with one set of bunks.

Peterkin, to the extent possible, will attempt to meet your room preference, though this may not be possible, depending on the number of attendees.

Some attendees prefer to stay off-sight and come to camp for the daily activities. Options for this include the locations below. Those who choose to stay offsite will have a separate rate which just covers the cost of food.

Koolwink (approx. 6 miles/11 minutes from Peterkin): 304-822-3595 www.koolwink.com

South Branch Inn Romney (approx. 8 miles/15 minutes from Peterkin): 304-822-2444 www.southbranchinn.com

Please Select Your Lodging Preference *

Please list names of other attendees with whom you wish to share a room:

General Disclaimer:

I give my permission for my full participation in events associated with Peterkin Camp and Conference Center, including but not limited to trail hiking and campfire activities. I give my permission for photographs or video footage of me to be used by The Diocese of West Virginia and Peterkin Camp and Conference Center for promotional purposes (brochures, on diocesan websites, promotional videos, Facebook groups, YouTube, etc). I agree to hold the Diocese of West Virginia, Peterkin Camp and Conference Center, and any associated agencies and persons harmless and waive any claims for payment for accident, injury, disability or damages to my person or property arising out of or connected with my participation in any activity related to the aforementioned activity. I accept that possession or use of banned substances at camp may result in punishment including but not limited to expulsion from Peterkin without refund and/or notification of law enforcement.

Click to Agree *

I agree

I do not agree

Child (3-17 years, must be accompanied by an adult) Full Rate: Includes Lodging Friday and Saturday nights, Breakfast/Lunch/Dinner on Saturday, and Breakfast on Sunday 0

Peterkin Retreat Registration Form - Peterkin 2024 Fall Hiking Weekend

Welcome to Peterkin!

This registration is for Peterkin Fall 2024 Hiking Retreat, November 1st-3rd.

Attendee Information

Attendee First Name *

Attendee Last Name *

I am a Parent/Guardian in this family registration

Yes

No

Phone Number *

Attendee Email Address *

Mailing Address *

Mailing Address Line 2

Mailing City *

Mailing State *

Mailing Zip Code *

Food Allergies - Common (Dropdown - select all that apply)

Dietary Preferences *

Food allergies - Other

Other Dietary Preferences *

Peterkin will attempt to meet your dietary preferences, but if you have a very restricted diet, we recommend that you provide some of your own food.

Lodging Preferences

For those staying over, Peterkin has two primary lodging options.

Gravatt Hall has individual rooms with one to four beds, including some bunk beds, and shared bathrooms accessed from shared hallways.

The Youth Lodges have rooms containing four bunks/eight beds per room, and bathrooms within each room, along with one room per lodge with one set of bunks.

Peterkin, to the extent possible, will attempt to meet your room preference, though this may not be possible, depending on the number of attendees.

Some attendees prefer to stay off-sight and come to camp for the daily activities. Options for this include the locations below. Those who choose to stay offsite will have a separate rate which just covers the cost of food.

Koolwink (approx. 6 miles/11 minutes from Peterkin): 304-822-3595 www.koolwink.com

South Branch Inn Romney (approx. 8 miles/15 minutes from Peterkin): 304-822-2444 www.southbranchinn.com

Please Select Your Lodging Preference *

Please list names of other attendees with whom you wish to share a room:

General Disclaimer:

I give my permission for my full participation in events associated with Peterkin Camp and Conference Center, including but not limited to trail hiking and campfire activities. I give my permission for photographs or video footage of me to be used by The Diocese of West Virginia and Peterkin Camp and Conference Center for promotional purposes (brochures, on diocesan websites, promotional videos, Facebook groups, YouTube, etc). I agree to hold the Diocese of West Virginia, Peterkin Camp and Conference Center, and any associated agencies and persons harmless and waive any claims for payment for accident, injury, disability or damages to my person or property arising out of or connected with my participation in any activity related to the aforementioned activity. I accept that possession or use of banned substances at camp may result in punishment including but not limited to expulsion from Peterkin without refund and/or notification of law enforcement.

Click to Agree *

I agree

I do not agree

Child (Under 3 years, must be accompanied by an adult) - no charge 0

Peterkin Retreat Registration Form - Peterkin 2024 Fall Hiking Weekend

Welcome to Peterkin!

This registration is for Peterkin Fall 2024 Hiking Retreat, November 1st-3rd.

Attendee Information

Attendee First Name *

Attendee Last Name *

I am a Parent/Guardian in this family registration

Yes

No

Phone Number *

Attendee Email Address *

Mailing Address *

Mailing Address Line 2

Mailing City *

Mailing State *

Mailing Zip Code *

Food Allergies - Common (Dropdown - select all that apply)

Dietary Preferences *

Food allergies - Other

Other Dietary Preferences *

Peterkin will attempt to meet your dietary preferences, but if you have a very restricted diet, we recommend that you provide some of your own food.

Lodging Preferences

For those staying over, Peterkin has two primary lodging options.

Gravatt Hall has individual rooms with one to four beds, including some bunk beds, and shared bathrooms accessed from shared hallways.

The Youth Lodges have rooms containing four bunks/eight beds per room, and bathrooms within each room, along with one room per lodge with one set of bunks.

Peterkin, to the extent possible, will attempt to meet your room preference, though this may not be possible, depending on the number of attendees.

Some attendees prefer to stay off-sight and come to camp for the daily activities. Options for this include the locations below. Those who choose to stay offsite will have a separate rate which just covers the cost of food.

Koolwink (approx. 6 miles/11 minutes from Peterkin): 304-822-3595 www.koolwink.com

South Branch Inn Romney (approx. 8 miles/15 minutes from Peterkin): 304-822-2444 www.southbranchinn.com

Please Select Your Lodging Preference *

Please list names of other attendees with whom you wish to share a room:

General Disclaimer:

I give my permission for my full participation in events associated with Peterkin Camp and Conference Center, including but not limited to trail hiking and campfire activities. I give my permission for photographs or video footage of me to be used by The Diocese of West Virginia and Peterkin Camp and Conference Center for promotional purposes (brochures, on diocesan websites, promotional videos, Facebook groups, YouTube, etc). I agree to hold the Diocese of West Virginia, Peterkin Camp and Conference Center, and any associated agencies and persons harmless and waive any claims for payment for accident, injury, disability or damages to my person or property arising out of or connected with my participation in any activity related to the aforementioned activity. I accept that possession or use of banned substances at camp may result in punishment including but not limited to expulsion from Peterkin without refund and/or notification of law enforcement.

Click to Agree *

I agree

I do not agree

Adult SATURDAY ONLY rate: includes Breakfast/Lunch/Dinner 0

Peterkin Retreat Registration Form - Peterkin 2024 Fall Hiking Weekend

Welcome to Peterkin!

This registration is for Peterkin Fall 2024 Hiking Retreat, November 1st-3rd.

Attendee Information

Attendee First Name *

Attendee Last Name *

I am a Parent/Guardian in this family registration

Yes

No

Phone Number *

Attendee Email Address *

Mailing Address *

Mailing Address Line 2

Mailing City *

Mailing State *

Mailing Zip Code *

Food Allergies - Common (Dropdown - select all that apply)

Dietary Preferences *

Food allergies - Other

Other Dietary Preferences *

Peterkin will attempt to meet your dietary preferences, but if you have a very restricted diet, we recommend that you provide some of your own food.

Lodging Preferences

For those staying over, Peterkin has two primary lodging options.

Gravatt Hall has individual rooms with one to four beds, including some bunk beds, and shared bathrooms accessed from shared hallways.

The Youth Lodges have rooms containing four bunks/eight beds per room, and bathrooms within each room, along with one room per lodge with one set of bunks.

Peterkin, to the extent possible, will attempt to meet your room preference, though this may not be possible, depending on the number of attendees.

Some attendees prefer to stay off-sight and come to camp for the daily activities. Options for this include the locations below. Those who choose to stay offsite will have a separate rate which just covers the cost of food.

Koolwink (approx. 6 miles/11 minutes from Peterkin): 304-822-3595 www.koolwink.com

South Branch Inn Romney (approx. 8 miles/15 minutes from Peterkin): 304-822-2444 www.southbranchinn.com

Please Select Your Lodging Preference *

Please list names of other attendees with whom you wish to share a room:

General Disclaimer:

I give my permission for my full participation in events associated with Peterkin Camp and Conference Center, including but not limited to trail hiking and campfire activities. I give my permission for photographs or video footage of me to be used by The Diocese of West Virginia and Peterkin Camp and Conference Center for promotional purposes (brochures, on diocesan websites, promotional videos, Facebook groups, YouTube, etc). I agree to hold the Diocese of West Virginia, Peterkin Camp and Conference Center, and any associated agencies and persons harmless and waive any claims for payment for accident, injury, disability or damages to my person or property arising out of or connected with my participation in any activity related to the aforementioned activity. I accept that possession or use of banned substances at camp may result in punishment including but not limited to expulsion from Peterkin without refund and/or notification of law enforcement.

Click to Agree *

I agree

I do not agree

Child (3-17 years, must be accompanied by an adult) SATURDAY ONLY rate: Includes Breakfast/Lunch/Dinner 0

Peterkin Retreat Registration Form - Peterkin 2024 Fall Hiking Weekend

Welcome to Peterkin!

This registration is for Peterkin Fall 2024 Hiking Retreat, November 1st-3rd.

Attendee Information

Attendee First Name *

Attendee Last Name *

I am a Parent/Guardian in this family registration

Yes

No

Phone Number *

Attendee Email Address *

Mailing Address *

Mailing Address Line 2

Mailing City *

Mailing State *

Mailing Zip Code *

Food Allergies - Common (Dropdown - select all that apply)

Dietary Preferences *

Food allergies - Other

Other Dietary Preferences *

Peterkin will attempt to meet your dietary preferences, but if you have a very restricted diet, we recommend that you provide some of your own food.

Lodging Preferences

For those staying over, Peterkin has two primary lodging options.

Gravatt Hall has individual rooms with one to four beds, including some bunk beds, and shared bathrooms accessed from shared hallways.

The Youth Lodges have rooms containing four bunks/eight beds per room, and bathrooms within each room, along with one room per lodge with one set of bunks.

Peterkin, to the extent possible, will attempt to meet your room preference, though this may not be possible, depending on the number of attendees.

Some attendees prefer to stay off-sight and come to camp for the daily activities. Options for this include the locations below. Those who choose to stay offsite will have a separate rate which just covers the cost of food.

Koolwink (approx. 6 miles/11 minutes from Peterkin): 304-822-3595 www.koolwink.com

South Branch Inn Romney (approx. 8 miles/15 minutes from Peterkin): 304-822-2444 www.southbranchinn.com

Please Select Your Lodging Preference *

Please list names of other attendees with whom you wish to share a room:

General Disclaimer:

I give my permission for my full participation in events associated with Peterkin Camp and Conference Center, including but not limited to trail hiking and campfire activities. I give my permission for photographs or video footage of me to be used by The Diocese of West Virginia and Peterkin Camp and Conference Center for promotional purposes (brochures, on diocesan websites, promotional videos, Facebook groups, YouTube, etc). I agree to hold the Diocese of West Virginia, Peterkin Camp and Conference Center, and any associated agencies and persons harmless and waive any claims for payment for accident, injury, disability or damages to my person or property arising out of or connected with my participation in any activity related to the aforementioned activity. I accept that possession or use of banned substances at camp may result in punishment including but not limited to expulsion from Peterkin without refund and/or notification of law enforcement.

Click to Agree *

I agree

I do not agree