Retreat Registration 2019 (Pay By Credit Card)

Please fill out this form and click submit.

Family Name

*

Contact Person Name

*

Email

*

This address will receive a confirmation email

Secondary Email

This address will receive a confirmation email

Fill out one form section for each member of your family. The cost will be added up at the bottom of the form. Registration fees are capped at $200 or about the cost of three family members. If the cost of retreat is more than you can afford to pay right now, please let us know how much assistance you need. We want everyone to participate, regardless of current financial situation.

If you would like to contribute to assist those who might not be able to pay the full registration right now, please let us know how much you'd like to give.

Notes for retreat committee: dietary needs, financial support requests

Family Member #1

Name

*

Age/Grade

*

Please select one option.

<5yo K-5th Middle School High School Adult

Retreat Fee

The Whole Weekend (2 or more days) ($55) Just Friday or Saturday ($35) Just Sunday (includes lunch) ($10)

Amount

Meals You Plan To Attend

*

Please select all that apply.

Friday Night Snack Saturday Breakfast Saturday Lunch Saturday Dinner Saturday Night Snack Sunday Breakfast Sunday Lunch

Lodging

Family Dorm Room (fits 4) ($15) Family Cabin (for families with more than more than 4) ($15) Men's Cabin ($15) Women's Cabin ($15) MYF Cabin ($15) Rustic Cabin ($5) Camping ($5) Sleeping at Home ($0)

Amount

Family Member #2

Name

Age/Grade

Please select one option.

<5yo K-5th Middle School High School Adult

Retreat Fee

No Second Family Member ($0) The Whole Weekend (2 or more days) ($55) Just Friday or Saturday ($35) Just Sunday (includes lunch) ($10) <5yo (0)

Amount

Meals You Plan To Attend

Please select all that apply.

Friday Night Snack Saturday Breakfast Saturday Lunch Saturday Dinner Saturday Night Snack Sunday Breakfast Sunday Lunch

Lodging

No 2nd family member ($0) Family Dorm (fits 4) ($15) Family Cabin (for families with more than more than 4) ($15) Men's Cabin ($15) Women's Cabin ($15) MYF Cabin ($15) RusticCabin ($5) Camping ($5) Sleeping at Home ($0) <5yo ($0)

Amount

Family Member #3

Name

Age/Grade

Please select one option.

<5yo K-5th Middle School High School Adult

Retreat Fee

No Third Family Member ($0) The Whole Weekend (2 or more days) ($55) Just Friday or Saturday ($35) Just Sunday (includes lunch) ($10) <5yo ($0)

Amount

Meals You Plan To Attend

Please select all that apply.

Friday Night Snack Saturday Breakfast Saturday Lunch Saturday Dinner Saturday Night Snack Sunday Breakfast Sunday Lunch

Lodging

No 3rd family member ($0) Family Dorm (fits 4) ($5) Family Cabin (for families with more than 4) ($5) Men's Cabin ($5) Women's Cabin ($5) MYF Cabin ($5) Rustic Cabin ($5) Camping ($5) Sleeping At Home ($0) <5yo ($0)

Amount

Family Member #4

Name

Age/Grade

Please select one option.

<5yo K-5th Middle School High School Adult

Retreat Fee $0

Meals You Plan To Attend

Please select all that apply.

Friday Night Snack Saturday Breakfast Saturday Lunch Saturday Dinner Saturday Night Snack Sunday Breakfast Sunday Lunch

Lodging

No 4th family member ($0) Family Dorm ($0) Family Cabin ($0) Men's Cabin ($0) Women's Cabin ($0) MYF Cabin ($0) Rustic Cabin ($0) Camping ($0) Sleeping At Home ($0)

Amount

Family Member #5

Name

Age/Grade

Please select one option.

<5yo K-5th Middle School High School Adult

Retreat Fee $0

Meals You Plan To Attend

Please select all that apply.

Friday Night Snack Saturday Breakfast Saturday Lunch Saturday Dinner Saturday Night Snack Sunday Breakfast Sunday Lunch

Lodging

No 5th family member ($0) Family Dorm ($0) Family Cabin ($0) Men's Cabin ($0) Women's Cabin ($0) MYF Cabin ($0) Rustic Cabin ($0) Camping ($0) Sleeping at home ($0)

Amount

Family Member #6

Name

Age/Grade

Please select one option.

<5yo K-5th Middle School High School Adult

Retreat Fee $0

Meals You Plan To Attend

Please select one option.

Friday Night Snack Saturday Breakfast Saturday Lunch Saturday Dinner Saturday Night Snack Sunday Breakfast Sunday Lunch

Lodging

No 6th family member ($0) Family Dorm ($0) Family Cabin ($0) Men's Cabin ($0) Women's Cabin ($0) MYF Cabin ($0) Rustic Cabin ($0) Camping ($0)

Amount

Family Member #7

Name

Age Grade

Please select one option.

<5yo K-5th Middle School High School Adult

Retreat Fee $0

Meals You Plan To Attend

Please select all that apply.

Friday Night Snack Saturday Breakfast Saturday Lunch Saturday Dinner Saturday Night Snack Sunday Breakfast Sunday Lunch

Lodging

No 7th member ($0) Family Dorm ($0) Family Cabin ($0) Men's Cabin ($0) Women's Canin ($0) MYF Cabin ($0) Rustic Cabin ($0) Camping ($0) Sleeping at home ($0)

Amount

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

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