Mothers' Retreat Registration
October 24 - 27, 2024, at Chico Hot Springs in Pray Montana
Once you register you are guaranteed a spot at the retreat. This form will automatically shut off once 20 moms have registered.
Feel free to reach out with any questions to pam@breathinisbelievin.org
Name
*
First Name
Last Name
Email
*
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Phone Number
Please enter a valid phone number.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please let us know if you have any special needs such as diet, mobility or other accommodations.
If you want to request a specific roommate, list their name here. If she also lists you, we’ll honor your request.
What are the ages of your child/children who are living with CF?
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Please upload two photos featuring both yourself and you alongside your children/family.
*
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Please do not use my photos publicly
Where did you hear about the retreat?
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Is this your first time attending?
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Yes
No
The retreat begins at 3:00 on Thursday, October 24th and ends at 11:00 am on Sunday, October 27th. Please register only if you are able to be present for the full retreat. Please let us know if you have questions about travel to Chico Hot Springs Resort in Pray, MT.
I agree to be present for the full retreat
A $100 refundable deposit is due upon registration. This fee will be refunded after your participation at the end of the retreat on Sunday, October 27th at 11:00am
Deposit
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$100 Deposit
$100 Deposit is due upon registration. Electronic payment can be made here or you can mail a check to CDF P.O. Box 7361, Bozeman, MT 59771
$
100.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
I wish to donate my $100 deposit to the Cody Dieruf Foundation
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