Senior Retreat Registration Registration FormName *Nametag Name [2nd Adult] Nametag Mailing Address City Zip Email *Phone *Church Name and City If you are registering more than two attendees, please add the additional attendee Name(s) and Name tag(s) in this section. Dietary Restrictions including any food allergies also. Please specify the name of the person who has restrictions and/or food allergies. This will be kept confidential. HOUSING SPECIFICS FOR THIS EVENTPlease select all that apply: *Staying at the Retreat ($180 - includes two nights, five meals)Request Private Cabin at the Retreat ($60 - additional charge)Request RV Space at the Retreat (no additional charge)Staying off-campus ($130 - includes five meals)Number of attendees Request Scholarship? *YESNOPayment Options: *OnlineMail-in CheckEmailSubmit
