Men’s Retreat

Date: January 13–14, 2023 (15th optional)
Begins: January 13th check-in 4:30–6:30 p.m. CST
Ends: January 14th at 4:30 p.m. CST (optional Sunday check-out by 9 a.m.)
Location: Barren Heights Retreat Center
Address: 145 Yacht Club Rd., Scottsville, KY 42164
Deposit Required: $50 for fathers of children with disabilities, $120 for BH volunteers

Join Men’s Ministry guides Joe Rose, Trent Bates, John Weires, Rick Estes, and Bill Reynolds on this overnight stay at Barren Heights as we provide biblical encouragement, refreshment, relaxation, and recreation.

Light snacks provided Friday, breakfast & lunch provided Saturday. Optional Saturday dinner not included.

We require a deposit* to reserve your spot for this retreat ($120 volunteers, $50 fathers of children with disabilities). Once your application has been approved, you will receive a confirmation email containing the link to our payment portal. We will wrap up around 4:00 p.m. Saturday. However, we want to provide optional time for Q&A, rest, and reflection. Feel free to stay over Saturday evening as our group and leaders will dine at a local restaurant at 4:30 p.m. (dining cost on your own) and enjoy evening fun and fellowship. *NOTE: The required deposit is 100% refundable to parents who have children with physical or developmental disabilities.

Men's Retreat Application

Full Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth*
MM slash DD slash YYYY
Email*
Phone Number*

Format: (xxx) xxx-xxxx
Food Restrictions (if any)*
Emergency Contact Full Name*
Emergency Contact Phone*

Format: (xxx) xxx-xxxx
How did you learn about Barren Heights?*
Do you have a child with a physical or developmental disability?*
- Yes
- No
What are your hopes and expectations for the weekend retreat?*
Have you attended a Barren Heights retreat before?*
Are you open to sharing a cabin with one other dad at this retreat?*
I'd like to receive email updates from Barren Heights!
- Yes!
All application information is kept confidential. Application information may be shared with retreat volunteers so they are better equipped to serve your family. This information will not be distributed or used for marketing purposes.

Hold Harmless Agreement

By checking the boxes below you are agreeing on behalf of your family to an electronic signature.
Please check if you agree to the following statements.*
- I give my consent that the information given at registration may be communicated with leaders and volunteers for the purpose of being equipped to provide the best care and assistance possible to my family.
- I give my consent that photographs, interviews and audio/visual recordings during the course of the event may be used by Barren Heights for training, promotion, and fundraising.
- I release Barren Heights, its directors, and volunteers, and the Retreat Center facility from all actions, damages, or personal injuries which may occur to me or a member of my family. I understand that in the event of a minor injury, I, or a member of my family may receive first aid treatment. I will be informed as soon as possible of any injury or condition of one of my family members and will be responsible thereafter for their care. In the event of an emergency, injury, or illness, emergency medical services and I will decide the best course of action. If the leaders are unable to reach me, I authorize them to take whatever action is necessary for the safety and health of my family members.
- I understand that in order for everyone to experience a sense of calm, peaceful relaxation, the Retreat Center is an alcohol, drug, and smoke-free environment. Use of cell phones is discouraged except when necessary.
- I hereby release and agree to hold Barren Heights and Harvest Heights harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss. I understand that this release discharges Barren Heights and Harvest Heights from any liability or claim that I, my heirs, or any personal representatives may have against them with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to any services rendered. This liability waiver and release extends to Barren Heights and Harvest Heights, together with all owners, partners, volunteers and employees.
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Men’s Retreat

Men’s Retreat

Men's Retreat Application

Hold Harmless Agreement

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