ASL Ladies Retreat

Name

First NameLast Name

Email

example@example.com

Phone Number

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

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you have any food allergies, dietary restrictions, or medical conditions we should be aware of as we prepare meals and plan activities for the retreat? (Examples: diabetes, gluten sensitivity, food allergies, asthma, mobility limitations, medication needs, etc.)

By registering for the ASL Ladies Retreat, I understand that participation in retreat activities involves inherent risks. I voluntarily assume all risks associated with attending and participating in retreat activities. I agree to release and hold harmless Camp Liberty, its staff, volunteers, and affiliated ministries from any liability for injury, loss, or damage that may occur during the retreat, except in cases of gross negligence. I also understand that Camp Liberty may use photos or video taken during the retreat for promotional purposes unless otherwise requested in writing.

Registration Expenses

Registration Fee

Registration fee is due at the time of registration and is applied toward the total retreat cost of $125. The remaining balance of $100 is due upon arrival.

$25.00

Final Retreat Cost

If you are paying with a church group or plan to pay upon arrival, you may leave this option unselected.

$100.00

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year