2023 Unveiled Women's Retreat Registration Form Marysville Foursquare Church 11911 State Ave Marysville, WA 98271 www.m4church.com

FINDING I AM just as i am The Firs 4605 Cable St. Bellingham, WA. 98229

$50 deposit(To reserve a bed. Refund is not guaranteed) Make check payable to M4church I memo: Women's Retreat 
or full payment of $225

FULL PAYMENT AND REGISTRATION FORM MUST BE SUBMITTED NO LATER THAN JAN. 15.23 FOR $199 OR FEB. 24. 23 FOR $225

Please read carefully, complete the form below, and sign

Family Doctor: Emergency Contact Name: Phone:

Medical Retreat Liability Release

I understand that in the event of an emergency, M4church and their representatives, will make every effort to contact those people listed on this form. In the event that M4church is unable to contact myself or the emergency contact, listed above, I give my permission to the physician selected by the camp management to secure treatment for myself.

I understand that completion of this medical form with my signature releases M4church, M4church staff, The Firs, The Firs staff, all faculty, officers, and management from any liability and shall not be held responsible for articles lost, stolen, or left behind.

Individual insurance coverage will be responsible for any medical needs during the event and will also be responsible for any extended