Family Retreat Registration Form

2026 Family Retreat Registration Form

March 6 - March 8 | Circle Lake Retreat Center
Are you attending:*

Full WeekendSaturday Only
Are you looking to register an Individual or a Family?

Individual (must be above 18 years old)Family

Registrant Name*

First NameLast Name
Email *
example@example.com
Cell Number*

Mother/Guardian Name*

First NameLast Name
Email *
example@example.com
Cell Number*
Will you be attending the retreat?*

YesNo
Father/Guardian Name*

First NameLast Name
Email *
example@example.com
Cell Number*
Will you be attending the retreat?*

YesNo
Would you like to register any children?*

YesNo

How many children are you looking to register?*
Child 1 Name:*

First NameLast Name
Age (Child 1)*
Grade (Child 1)*
Allergies (Child 1)*
Child 2 Name:*

First NameLast Name
Age (Child 2)*
Grade (Child 2)*
Allergies (Child 2)*
Child 3 Name:*

First NameLast Name
Age (Child 3)*
Grade (Child 3)*
Allergies (Child 3)*
Child 4 Name:*

First NameLast Name
Age (Child 4)*
Grade (Child 4)*
Allergies (Child 4)*

Are you attending:*

Full WeekendSaturday Only

Select an Answer:*

Yes, Sponsorship Level 1 (50 $)Yes, Sponsorship Level 2 (100 $)No

Select a Payment Method*

Pay OnlinePay by Check or Cash

Payer Name*

First NameLast Name
Cell Number*
Email *
example@example.com
Should be Empty: