Online Registration for

Men's Retreat 2010

 

 

  I am registering by September 27th

 -$15.00
  Weekend Registration, with Lodging $150.00

  Weekend Registration, NO Lodging

(Hotel group rates are available for $85 per night if booked by 9/17.  Please call Holiday Inn and mention Camp AREV: 661- 248-1600)

$90.00
  Saturday only Registration $75.00
  I may need financial assistance for this retreat Total Amount Due

 

 

 

Name

Birthday

 Home Church

Address

Home Phone

City

State

Zip Code

E-mail

 Cell Phone/Work Phone
The best way to contact you Spouse's Name
 (If applicable)

 

 

 

Alternate Contact

 Home Phone              

Cell Phone

 Please list any allergies
or serious dietary restrictions.
 

 

 

 

T-Shirt Size

   Small    Medium    Large

    X-Large    XX-Large    XXX-Large