Registration Form

Registration Form

(due by December 15)
* Required fields
Last Name*
Pastor First Name*
Spouse First Name
Church Name*
Church Location (City/State)*
Email*
Registration:
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Double Occupancy (Friday evening meal, Saturday continental breakfast, Saturday lunch buffet and Sunday morning buffet breakfast are included. Saturday dinner is not provided as this is "free time")
$400.00

Single Occupancy(Friday evening meal, Saturday continental breakfast, Saturday lunch buffet and Sunday morning buffet breakfast are included. Saturday dinner is not provided as this is "free time")
$300.00

Total

$0.00
Additional information:

Handicap accessible room is needed.
Please verify that you are human*
If your plans change and you are unable to attend, you must call the district office (610-366-0310) to cancel by January 5 or full payment will be required. “No-shows” will be responsible to pay the full retreat registration fee.

Payment Methods

Debit or Credit Card

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