Weekend Retreat Registration
(Best filled out on a desktop computer)
Full Name
*
First Name
Last Name
Address
*
E-mail
*
Phone Number
*
Church you attend
*
Weekend you are interested in
*
Men's Retreat
Women's Retreat
Do you have any health concerns or dietary restrictions we should know about?
*
Yes
No
Please list concerns and dietary restrictions.
How did you come to know Jesus as your personal Savior?
*
Briefly share your spiritual journey for the last 12 months.
*
What do you hope to get out of this experience?
*
Is there anything else you feel is important for us to know about you?
Agreements
By checking these boxes you are affirming that you agree with these statements.
*
I acknowledge and accept that this is a Faith Journey and that everything I will be involved in will seek to point to Jesus Christ as Lord and Savior.
I accept full financial responsibility for the costs of this experience.
I will help to create a safe atmosphere, maintain confidentiality and participate in all activities.
Deposit
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USD
Deposit amount ($125) Full amount ($250)
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