2020 Lay Spiritual Retreat

IMPORTANT!!!

You MUST complete all mandatory fields (marked with *) as well as the "SUBMIT" button at the bottom of the form.

You will automatically receive a "THANK YOU" email to confirm that we've received your online registration.

Any additional questions or concerns should be directed to Anne Woolner (Registrar) at: annewoolner@hotmail.com

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

I give permission for my email address to be shared with participants of this retreat.*

YesNo

Congregation*

Room Preference - Please note that single rooms are limited and will be assigned on a first-come, first-served basis.*

DoubleSingleCommuter - No room required

Roommate Preference (if applicable)

Dietary and/or Accessibility Requirements

Payment Options - PLEASE SELECT ONLY ONE.*

I will pay for my registration fee online via PayPal or by Credit Card (below).I will send a cheque (payable to "Eastern Synod") via regular mail to The Eastern Synod, 74 Weber St. W Kitchener, ON N2H 3Z3. (Please note -do NOT complete the next payment section if paying by cheque)

On-Line Payment SELECT ONE *ONLY IF PAYING ONLINE*

All-Inclusive Registration Fee$325.00CAD

Commuter Registration Fee$160.00CAD

Total $0.00CAD

Enter the message as it's shown*