Registration Form

Northeast District Winter Retreat Registration Form

Paying with a check (due by December 15)
* Required fields
Last Name*
Pastor First Name*
Spouse First Name
Church Name*
Church Location (City/State)*
Email*
example@example.com
My Products
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Double Occupancy(Friday evening buffet dinner, Saturday breakfast buffet, Sunday morning breakfast buffet are included. Saturday lunch & dinner are not provided as this is "free time")
$400.00

Single Occupancy(Friday evening buffet dinner, Saturday breakfast buffet, Sunday morning breakfast buffet are included. Saturday lunch & dinner are 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*
Payment Method:*

Mail Payment (Northeast District, 6737 Cetronia Road, Allentown, PA 18106)
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.
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Northeast District Winter Retreat Registration Form