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Participant Contact Information
Name
*
Email
*
Phone Number
*
Address
*
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
AA
AE
AP
Church Name
*
Church City, State
*
Registration Information
Registration Options
*
Full Retreat ($35.00)
2-Day Package ($24.00)
1-Day Package ($18.00)
Housing
*
Room w/ restroom (per person) ($24.00)
Room - no restroom (per person) ($15.00)
RV, Tent, Camper fee (per unit) ($15.00)
Bedding (per person) ($10.00)
No housing needed ($0.00)
NOTE: Single Adults
will share
a room with others.
Meals
I am gluten-free
Thursday Dinner ($8.50)
Friday breakfast ($6.00)
Friday Lunch ($8.00)
Friday Banquet ($9.00)
Saturday breakfast ($6.00)
Saturday Lunch ($8.00)
Convenience Fee
$3.00
Running Total
$3.00
Total
$3.00
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