ACC Pine Valley Retreat Individual Application
  • ACC Pine Valley Retreat Individual Application

    ACC Pine Valley Retreat Individual Application

    This is the application form for individual registrations. If you would like to register more than one person, please click the "Family" application. All rates include a $20 non-refundable registration and processing fee. You are not fully registered until the application, liability form(s), and full payment have been received.
  • Marital Status*
  • Gender*
  • Format: (000) 000-0000.
  • I am willing to volunteer in the following ways:

  • Nominees for PV Committee

    Please note that the term of two brothers on the Pine Valley Committee, Michael Greeninger, Andrew Gerber is expiring this year. We are taking names for two potential nominees at this time. The current P.V. Committee is Ben Albu, Bryan Bodjanac, Andrew Gerber, Michael Greeninger, and Arnold Sabo.

  • Rates*

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                                      Motel - Full Time - ages 12+

                                      Full time with meals, linens included

                                      $310.00$310.00
                                        
                                      Dorm - Full Time - ages 12+

                                      Full time with meals

                                      $270.00$270.00
                                        
                                      Family Dorm - Full Time - age 12+ (min. 6 people)

                                      Full time with meals

                                      $270.00$270.00
                                        
                                      Dorm - Part Time (1 night) - ages 12+

                                      3 meals

                                      $200.00$200.00
                                        
                                      Dorm - Part Time (2 nights) - ages 12+

                                      6 meals

                                      $230.00$230.00
                                        
                                      Ages 8-11 Full Time

                                      Full time with meals

                                      $135.00$135.00
                                        
                                      Ages 4-7 - Full Time

                                      Full time with meals

                                      $120.00$120.00
                                        
                                      Ages 3 and under - Full Time

                                      Full time with meals

                                      Free$ Free
                                        
                                      Day Registration - Part Time - Child (ages 3 and under)
                                      Free$ Free
                                        
                                      Day Registration - Part Time - ages 12+

                                      No meals

                                      $50.00$50.00
                                        
                                      Day Registration - Part Time - ages 4-11

                                      Includes lunch OR dinner

                                      $40.00$40.00
                                        
                                      Day Registration - Part Time - ages 12+

                                      Includes lunch OR dinner

                                      $65.00$65.00
                                        
                                      Day Registration - Part Time - ages 4-11

                                      Includes lunch AND dinner

                                      $55.00$55.00
                                        
                                      Day Registration - Part Time - ages 12+

                                      Includes lunch AND dinner

                                      $85.00$85.00
                                        
                                      Full Registration - Off-site Lodging

                                      ALL meals

                                      $160.00$160.00
                                        
                                      Linens (per bed)
                                      $35.00$35.00
                                        
                                      Donation

                                      as unto the Lord

                                      $5.00$5.00
                                      Amount Quantity Price
                                      $5 $5.00$5.00
                                      $15 $15.00$15.00
                                      $25 $25.00$25.00
                                      $50 $50.00$50.00
                                      $100 $100.00$100.00
                                      $150 $150.00$150.00
                                      $200 $200.00$200.00

                                      Item subtotal:$0.00$0.00
                                        
                                      Total
                                      $0.00$0.00

                                    • Payment Methods

                                      Choose from one of the PayPal options to make your payment.

                                    • Should be Empty: