Art Therapy Retreat for Christian Women

Full name*

First NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState

Post CodeCountry
E-mail*
example@example.com
Phone Number*
Please enter a valid phone number.
Emergency contact*

First NameLast Name
Emergency contact phone number*
Please enter a valid phone number.
Relationship (i.e. Spouse / Parent)*
This retreat is cost effective in-part because the sleeping arrangements are cabins with bunkhouses. The cabins have electricity and heating. However, this is simply a disclosure that you will likely be sharing the cabin/bunkhouse with others and will need to supply your own linens/pillows/sleeping bag.*

I acknowledge that the accommodations at the retreat venue (North Star Bible Camp & Retreat Center) are cabins with bunkhouses, so I will very likely share accommodations with other women & will bring my own twin-sized bedding or sleeping bag.
Do you have any dietary requirements/allergies?*
Your spot at the retreat is not officially reserved until payment is received. In order to pay, you could mail a check to "Megan Gunkel," using the address below, or pay with a card over the phone (Additional processing fees will be applied). Once payment is received, all sales are final after 7 days.

Mail checks to: Megan Gunkel, P.O. Box 221, Willow, AK 99688
Would you prefer to pay through mailing a check, or with a debit/credit card?

Mailing a checkDebit/credit card (Processing fees will be applied)
I confirm that my spot is not reserved until my payment is received. I also confirm I understand that once my payment is received, I will not receive a refund after 7 days, in the event that I am no longer able to attend the retreat.*

Yes, I have read, understand, and agree to the terms above.
Should be Empty: