Young Adult Retreat Registration Form 2026

Young Adult Retreat Registration Form 2026

Eatern Canada Church of God of Prophecy
DEV Hotel & Conference Centre

1950 Montreal Rd. Cornwall, ON K6H 6L2
May 15-17, 2026

Please Note: Each roommate MUST submit a separate registration form.YOU ARE NOT FULLY REGISTERED UNTIL YOUR NON-REFUNDABLE DEPOSIT OF 100.00 IS SUBMITTED AT THE NATIONAL OFFICE.
Attendee Information:
Name*

First NameLast Name
Email *
example@example.com
Phone Number*
Gender*

MaleFemale
Please confirm you are of majority age (18+)*

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Local Church Name*
T-Shirt Size*
Emergency Information:
Emergency Contact's Name

First NameLast Name
Phone Number
Alt. Phone Number
Do you have any special dietary requirements? (eg: gluten-free (please specify if you are celiac), allergies, vegan etc…)

Retreat Rates (Please select):*

Quad Occupancy (4 in a room)

$300.00CAD

Triple Occupancy (3 in a room)

$340.00CAD

Double Occupancy (2 in a room)

$380.00CAD

Single Occupancy (1 in a room)

$520.00CAD Quantity

Enter coupon

Total

$0.00CAD

DEV Hotel & Conference Centre