Grace Faith Church

2014 Church-Wide Retreat Registration

Adults
Youth:
- ages 12 – 17, rooming with parent
ages 12 - 17, surcharge if rooming separately
ages 3 – 11
Children (under 3)
Family max:
Registrations Forms & Payment:
Cash or Checks payable to:

$225.00
$125.00
$ 33.00
$ 75.00
FREE
$650.00
submit to Irene Ng
GRACE FAITH CHURCH

(please indicate “Retreat” on memo line)
******** Donations to Retreat Scholarship Fund are welcome *******

First Name

This is a required question

Last Name

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Gender

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Address

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City

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State

Must match pattern

This is a required question

Zip Code

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Phone

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Email Address

Must be a valid email address

This is a required question

Transportation

This is a required question

I'm driving and can provide a ride for (#) of people

	1	2	3	4	5
						I have a big car!

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Where will you be leaving from?

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Where will you be returning to?

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Comfort (please choose only one)

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Name

Additional Family member 1

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Age

Must be a number

This is a required question

Gender

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Name

Additional Family member 2

This is a required question

Age

Must be a number

This is a required question

Gender

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Name

Additional Family Member 3

This is a required question

Age

Must be a number

This is a required question

Gender

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Comments/Requests

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