OA Unity Intergroup 2023 Retreat Registration Form

OA Unity Intergroup Fall 2023 Retreat

REGISTRATION FORM
A Walk Through the 12 Steps:
The Sunlight of the Spirit is the Solution

with Melissa C. and Patrick B.
DETAILS

WHEN:
October 13-15, 2023

LOCATION:
Cohutta Springs Retreat Center
1175 Cohutta Springs Rd
Crandall, GA 30711

QUESTIONS:
Contact Becca D. at (615) 486-9801 or dailyreprieve4me@gmail.com
YOUR INFORMATION

Note: Please complete one registration form per person. If you are a couple or sharing a room with others, each person will need to complete their own form and pay separately. Thanks!
Full Name*

First NameLast Name
Phone Number*
E-mail*
example@example.com
PROGRAM, MEALS, AND ROOM INFORMATION
A full refund can be given if cancellation is made prior to September 13th. Below is information regarding fees for rooms, meals, and the program.

ROOM INFORMATION (includes a room for Fri and Sat night, 4 meals - Sat breakfast, lunch, dinner, and Sun breakfast, and retreat program):

2 Queen Beds/Room (accessible room includes 1 queen bed, accessible balthroom on the 1st floor):
- 4 people/room = $223.91/person
- 3 people/room = $250.94/person
- 2 people/room = $305.04/person
- 1 person/room = $467.32/person
1 King Bed/Room:
- 2 people/room = $322.50/person
- 1 person/room = $492.96/person
PROGRAM AND MEAL OPTIONS (no room will be used):
- Daytripper (Saturday) Program = $45
- Daytripper Lunch = $20
- Daytripper Dinner = $20
- Weekend Program and Meals Only (no room) = $142.76
YOUR ROOM AND MEAL CHOICES
ROOM OPTIONS: (price includes room, 4 meals, and the weekend program)*
Select a room option.
Are you differently-abled needing an accessible room (1st floor room with 1 queen bed and accessible restroom)?

YesNo
PROGRAM/MEAL OPTIONS:*
Select a program/meal option.
ROOMMATE INFORMATION

Please enter information about your roommate(s) below. If you do not currently have a specified roommate, we will try to match you with someone. However, if we are unable to do so, you will be responsible for the cost of the room as described above.
Please, help me find a roommate:*

YesNoNo, but you can put someone in my room if needed.I do not need help with finding a roommate.
Roommate #1 Name and Phone Number:
Roommate #2 Name and Phone Number:
Roommate #3 Name and Phone Number:
OTHER INFORMATION

Please answer these additional questions.
Do you need

vegetarian food options?vegan food options?other? (please contact ______________ to explain)I don't need special food options.
Are you interested in volunteering to help with various retreat needs. (We will contact you about this as the retreat approaches and our needs are clearer.)

yesno
PAYMENT INFORMATION
PAYMENT CALCULATIONS
Enter your program/room/meal cost from your selections above.
Enter dollar amount here
Scholarship Fund: I will contribute the following amount to help anyone attend regardless of ability to pay:
Enter dollar amount here
Add the 2 numbers above to get your subtotal and enter it below:
Enter dollar amount here
Did you preregister?

YesNo
IF YOU CANNOT REMEMBER IF YOU PREREGISTERED, TEXT OR CALL BECCA D AT (615) 486-9801.

If you preregistered, subtract $100 from your subtotal and enter the your final registration cost below:

(hint: everyone who preregistered paid $100)
REQUESTS FOR SCHOLARSHIP

If you do not need a scholarship, skip to "AMOUNT TO PAY TODAY".
FOR THOSE REQUESTING SCHOLARSHIP ASSISTANCE: Enter how much will you need.
Enter dollar amount here
Please pay what you are able below. Scholarships will be honored on a first come-first served basis. You will be contacted to confirm your scholarship status.
AMOUNT TO PAY TODAY
Total Cost to Pay Now: (includes room/program/meals + scholarship donation - preregistration fee, if paid)

prevnext( X )
USD
Payments may be made via credit/debit card, PayPal, or Venmo using the links below. All of these options will be processed through Paypal. You do not need to download the PayPal app to use this function.

Alternatively, checks may be made to OA Unity Intergroup and mailed to:

Robin Vasa
525 Mariner Way
Chattanooga, TN 37402

If you need a different form of payment, please contact Robin by phone or text at (423) 503-6851.
**PLEASE NOTE: The "Pay Later" option may charge you now, so use caution when selecting it.

Payment Methods

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

OA Unity Intergroup Fall 2023 Retreat

YOUR INFORMATION

PROGRAM, MEALS, AND ROOM INFORMATION

YOUR ROOM AND MEAL CHOICES

ROOMMATE INFORMATION

OTHER INFORMATION

PAYMENT INFORMATION

REQUESTS FOR SCHOLARSHIP

AMOUNT TO PAY TODAY

**PLEASE NOTE: The "Pay Later" option may charge you now, so use caution when selecting it.