Fall Retreat 2023

CONTACT INFO

Registration Date

Name

Address

Phone (mobile preferred)

This address will receive a confirmation email

Home Church

Church/Organizational Role

If other, please specify:

Will your spouse also be attending:

No (skip the below) Yes (please fill out info below)

SPOUSAL INFO

Spouse First Name

Spouse Last Name

Spouse's Church/Organizational Role

If other, please specify:

ACCOMMODATIONS

I understand there are no elevators in the building.

I have no floor preference. I PREFER main floor accommodations. I NEED main floor accommodations. Commuting or staying offsite

I understand some rooms have private bathrooms.

I am willing to share a hallway bathroom. I PREFER a private bathroom. I NEED a private bathroom (additional $5 per night) Does not Apply

Dietary Restrictions

Vegetarian Nut Allergy Other None

Please be specific and add any details that might help us plan.

Please list any known allergies.

Room Reservation

$25~ Individual Registration (for those commuting or staying offsite, $25 for all sessions & meals). $95~ Individual Registration WITHOUT Private Bathroom ($25 registration for all sessions & meals, plus $35/person/night). $105~ Individual Registration WITH Private Bathroom ($25 registration, all sessions & meals, plus $40/person/night). $170.00 Couples Registration WITH Private Bathroom ($25 registration each, all sessions & meals, plus $60/couple per night). Option

PAYMENT

To pay by check select the "PAY LATER" option. Checks should be mailed to:
Maumee Valley Presbytery
P.O.Box 638164
Cincinnati, OH 45263

Select One

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Fall Retreat 2023

Description

Please Fix the Following