Fall Spiritual Formation Retreat "The Imprint of Christ"

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.

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)

Dietary Restrictions

Vegetarian Nut Allergy Pescetarian 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). $105~ Individual Registration WITH Private Bathroom ($25 registration, all sessions & meals, plus $40/person/night).

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 Spiritual Formation Retreat "The Imprint of Christ"

Description

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