Young Adults Retreat
Registration Form
Attendance Information
Name
*
First Name
Last Name
Gender
*
Male
Female
Select your attendance status:
*
Please Select
Single
Couple
Couple With Children
Birth Date
*
-
Month
-
Day
Year
Date
Age
*
Please list any additional details (i.e. number of children and ages if applicable, etc.)
Will you need housing accommodations?
*
Yes
No
Please list any dietary needs or food allergies:
Contact Information
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
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Friday Admission
Friday Evening Pass (No Overnight Accommodations)
$
25.00
CAD
Saturday Admission
Day Pass & Meals Included (No Overnight Accommodations)
$
50.00
CAD
Full Weekend Admission
Friday & Saturday Overnight Accommodations & Meals Included
$
85.00
CAD
Alumni Admission
Discounted Standard Admission for Alumni of Word of Life Bible Institute
$
75.00
CAD
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