Summer Retreat
July 2-5, 2010
River's Bend Guest Ranch

Please fill out the following form to register for the Summer Retreat. Press the Tab key between fields and the Submit button upon completion.


I. GENERAL INFORMATION
Name:
E-mail:
Street Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Work Phone:
Emergency Contact:
Relationship:
Phone:
II. SLEEPING ARRANGEMENTS
For 2010, we are going to River's Bend Guest Ranch in the Shenandoah Valley. The cost of the retreat is $200 per person and includes food.
Room Choice: Attending as Single (single bed) and prefer a single-gender room.
      Roommate's Name (otherwise assigned):
     

Attending as Single (single bed) and prefer a co-ed room.
      Roommate's Name (otherwise assigned):
     

Attending as Couple (double bed)
      Partner's Name:
III. FOOD ARRANGEMENTS
The price of the retreat includes food. The retreat organizers will supply all food and
non-alcoholic beverages.
Food Concerns: List any allergies you have:


List any food restrictions (vegetarian, vegan, lactose intolerant, etc.):
IV. WORKSHOPS AND ACTIVITIES
Workshops: Do you want to help with a workshop, worship, or any other activity?
Yes
No
Maybe

If yes, what? If you want to lead, what supplies would you need? We may (if it's cheap and we have the funds) be able to reimburse you.
Group Leaders: Would you like to be a Group Leader? This is a fun leadership position that fosters community and helps keep us more organized and tidy.
Yes
No
Maybe
V. CARPOOL ARRANGEMENTS
Carpool arrangements will be handled in our Summer Retreat Yahoo Group. Once you've completed registration, you will be invited to join this group.
VI. COMMENTS
Please post your comments here or tell us anything else that would make the retreat more enjoyable for you:
VII. RETREAT AGREEMENT
Please read and indicate your agreement by typing your full name into the Signature box below: I understand that the retreat organizers reserve the right to remove anyone from the retreat at any time, for any reason they deem appropriate. I agree to behave in a manner that is appropriate and cooperative in the effort to create a caring, sharing community.
Signature:

Contact the Registrar if you have questions.