Ladies Retreat

Slavic Christian Center Ladies Retreat

May 12-May 14th, 2022
Havilah Retreat Center

15000 Spirit Lake Hwy, Toutle, WA 98649
Please fill out form per individual person
Name *

First Name Last Name
Marital Statues
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *
E-mail *
example@example.com
Text Message Option *

Yes, I want to receive occasional text messages No, I prefer not to receive occasional text messages
Are you over 18?

Yes No
Parents Name

First Name Last Name
Parent Phone Number *
Parent E-mail *
example@example.com
Age
Emergency Contact

First Name Last Name
Phone Number
Please enter a valid phone number.
Home Church *
Will you need transportation?

Yes, I will need transportation to and from the retreat No, I will drive myself or carpool
Remember to bring: A Bible/notebook/pen, Sleeping bag, pillow, warm clothes Change of clothes, Clothes for Sauna, toiletries

For more information or help contact!

Nadya Ivliev: (253) 709-3388
I authorize Ladies Ministry/Havilah staff to give any emergency medical attention to me or my child as necessary. I will not hold Ladies Ministry/Havilah and its personnel liable for any accidents or illnesses in the retreat. I am not aware of any physical or other limitations that would keep me or my child from participating in the Retreat. If my child or I develop any cold or flu like symptoms before the event I will not attend the retreat. I understand that I am responsible for my child at the retreat. No person under the age of 16 is allowed at the the event with out a parent or guardian being present. By checking below, I have read and agree with the terms indicated above
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