Retreat Registration Form

*Name

*Phone number

*Email Address

For each snack/meal/night, please indicate the number that will be attending.
Put the number of adults in the first box, and the number of children (with ages) in the second, longer box.

# of Adults

# of Children - please indicate ages
(no need to repeat ages each time!)

Friday snack

Friday night sleeping

Saturday breakfast

Saturday lunch

Saturday dinner

Saturday snack

Saturday night sleeping

Sunday breakfast

Sunday lunch

**Please indicate if you have interest in the Saturday evening hayride (for an additional cost):

# of adults

# of children

Note: All rooms sleep at least 4 people, with either two double beds or a double bed, a single bed and a hideaway bed. Three rooms have a bunk bed and can sleep 5 people. There are also several adjoining rooms.

Additional Needs: (indicate number of additional items needed where appropriate)

Crib(s)

Roll away bed(s)

Pillow(s)

Blanket(s)

Special meals (type)

Directions to camp needed?

Yes
No

Other

Retreat Registration Form

For each snack/meal/night, please indicate the number that will be attending. Put the number of adults in the first box, and the number of children (with ages) in the second, longer box.

For each snack/meal/night, please indicate the number that will be attending.
Put the number of adults in the first box, and the number of children (with ages) in the second, longer box.