2017 Women's Retreat Registration Form

All women are welcome and invited to attend.

Name *
Name
Please indicate your most utilized phone number so we can contact you about the retreat, if necessary.
Please indicate your mailing address so materials can be sent to your home from the event organizer regarding the retreat.
Please indicate your rooming preference from the options below. We have set these preferences to allow the most room at the retreat. We may not be able to honor all single occupancy requests, depending on how many individuals attend the retreat. Please select from the list below and indicate in the message portion your strong preference for single occupancy if it is available. If you have a specific persons in mind as a roommate, please indicate such in the optional "Roommate Preference" field.
Please indicate any specific individuals you want in your room (if any)
Ask any questions or detail any allergies or restrictions you may have.
Contact the retreat organizer at the following e-mail address to discuss deposit amounts, where to send, etc. : bd401@verizon.net