Bethel EM Retreat Registration Form

Bethel EM Retreat

September 11-13, 2026
Full Name

First NameLast Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Home Church

Other
If other church, what is the name of your church?
Current Lifestage

Other
Please let us know for which meals you will be present (if not sure yet, please indicate to the best of your knowledge for now):
Please share any allergies, dietary restrictions or other health/medical concerns that we should be aware of during the retreat (for every person you are registering for the retreat).

FAMILY REGISTRATION

Please register spouse and children in this section. If not applicable, please go to the next page.
- Spouse's Name
  
  First NameLast Name
- Spouse's Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Spouse's Email
  example@example.com
- Child 1's Name
  
  First NameLast Name
- Child 1's Age
  As of September 11, 2026
- Child 2's Name
  
  First NameLast Name
- Child 2's Age
  As of September 11, 2026
- Child 3's Name
  
  First NameLast Name
- Child 3's Age
  As of September 11, 2026

Bethel EM Retreat