The Great Escape 2024

Name*

First NameLast Name

Nickname/ American Name

E-mail*

Confirmation Email

Mobile Number

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Mobile Copy

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

FemaleMale

SingleMarried

Age*

School*

Academic Major

Country of Origin*

Religion*

Total number of people(including yourself)*

Total(Copy)

Your T-Shirt Size*

Click Here to see the T-Shirt size chart to help you decide the right size for you.

You indicated the Total Number of People coming more than 1. Mention all additional people coming below. You will have to pay for them as well. Registering for people not your family members will automatically cancel your registration.

Name of family members coming with you & their relationship to you

Family Members(Copy)

Food restrictions and/or allergies to pet?

Indicate if you prefer vegetarian food or you have any other food restrictions so we can try to accommodate your need.

Any medical conditions that we need to know?

Housing preference

Mention if you like to be housed with someone else coming on this trip. We'll try our best to accommodate such requests but there are no guarantees. Spouses and families will be housed together. Only students of same gender will be housed together. Please note that housing is 2 or 4 persons to a room depending on what payment package you choose below unless you choose 1 person per room package.

Comments or questions

What do you hope to gain from this retreat?*

How or from whom did you hear about this retreat?*

Flyer, poster, BISM email, Coffee Hour email, friend, etc. If from a friend, please enter name of friend.

Agree

Refund Policy

Due to the nature of the trip, the following is the refund policy for cancellation:

Cancellations done on or before Jan 15,2025	100% of the registration fee refunded
Cancellations done between Jan 16 and Jan 31	75% of the registration fee refunded
Cancellations done between Feb 1 and Feb 15	50% of the registration fee refunded
Cancellations done after Feb 15	0% of the registration fee refunded

You can find replacement student to take your place,but they must be willing to agree to the participation statement and participate in all scheduled events

Do you want to pay in Installments? *

This option is only available for the 4 -person per room package. $65 due at time of registration and then 3 monthly payments of $70 for a total of $275

You have selected the installment option. On the next screen you will have the option to setup your installment plan. $65 is due at time of registration and then 3 monthly payments of $70 for a total of $275.

Registration Fee*

4 per Room (Student price)

For Adults who are students only. You will share the room (2 queen beds) with 3 other people

$275.00 Quantity
Item subtotal:$0.00

2 per Room (Student price)

For Adults who are students. You will share the room (2 queen beds) with another person. You will have your own bed.

$325.00 Quantity
Item subtotal:$0.00

Couple (Student price)

Price PER Couple. Both people qualify for this price if one of you is a student. You will have your own room.

$600.00 Quantity
Item subtotal:$0.00

4 per Room (Regular Non-student price)

For Adults who are non-students. You will share the room (2 queen beds) with 3 other people

$350.00 Quantity
Item subtotal:$0.00

2 per Room / Couple (Regular Non-student price)

For Adults who are non-students. You will share the room (2 queen beds) with another person. You will have your own bed/room.

$405.00 Quantity
Item subtotal:$0.00

Single Occupancy (Student/Non-student price)

For Adults. You will have the entire room to yourself

$512.00 Quantity
Item subtotal:$0.00

Children (Ages 12 -17)

Children ages 12-17 only

$180.00 Quantity
Item subtotal:$0.00

Children (Ages 6 - 12)

Children ages 6-11 only

$120.00 Quantity
Item subtotal:$0.00

Children (5 and Under)

Children ages 5 and under

$ Free Quantity
Item subtotal:$0.00

Enter coupon

Payment Methods

Debit or Credit Card

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

*Register for yourself & your family members only

Agree to Liability Waiver & Refund Policy Printed Below

Agreement to attend all scheduled events

Payment

Installment Payment Option