Retreat Registration

* Indicates required field

Name *

First

Last

Phone Number *

Additional family members attending, (if kids, includes ages): *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Anything else it would be helpful to know? *

Email *

Emergency Contact Name & Number: *

Dietary Restrictions or needs: *

Do you want sheets and towels provided, or will you bring your own? *

I/we will bring our own linens I/we would like linens provided for $10 extra

Retreat costs:
Adults - $120
Kids ages 6-11 - $60
Kids under 5 - Free
Family Max - $300

Scholarships available *

I/we would like scholarship assistance

Total to be paid: *

How will you make payment? *

Pay by check turned in to church Pay by credit card online

$50 deposit due at registration. Full amount due by Nov. 1.

Submit

To pay online - click the link to the right.
Please be sure you have submitted
your registration form first.