SERIOUS YOUTH RETREAT 2017

SERIOUS YOUTH RETREAT REGISTRATION FORM
Full Name*

First NameLast Name
COMPETITION!! Please give full name of person who recommended you to SERIOUS YOUTH RETREAT*
Address*

Street Address

Street Address Line 2

CityRegion

PostcodeCountry
Contact Number*

Area CodePhone Number
Birth Date*

MonthDayYear
Upon submission of the form you will receieve a Parental Consent form to be filled and signed by parent/guardian if you are under 18. Please return to your church youth leader or send back to miracleyouth.mcci@gmail.com
E-mail*
Gender*

MaleFemale
Next of Kin Name and Contact Number
Please enter Full Name and a contactable number
Dietary Requirements*

No Dietary RequirementsVegetarianGluten FreeVeganDiabetic
Disability or Medical Requirements
Please confirm if you have a disability or any specific medical requirements
Payment Method*

CashBank Transfer
Payment Plan*

Deposit (£35) & 3 Instalments (2x £35, 1 x £30)Deposit (£35) + Remaining Balance (£100)Full Payment (£135)
The DEPOSIT (£35) is required by Sunday 26th March 2017, which is non-refundable.

IF the Full Payment is paid, only £100 is refundable before Sunday 25th June 2017.

The Full balance of £135 is required by 25th June 2017, once this is paid, you are guaranteed a place at the Retreat and all monies become non-refundable.

Instalment Dates are the following:

1. Sunday 26th March 2017 (£35)

2. Sunday 30th April 2017 (£35)

3. Sunday 28th May 2017 (£35)

4. Sunday 25th June 2017 (£30).

Please note, deposits are non refundable. No payments are refundable post 25th June 2017.

Please do not hesitate to contact us with any queries.
Click here to confirm you have read the above details and confirm you will be attending the youth retreat*

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How did you hear about Serious Youth Retreat*

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SERIOUS YOUTH RETREAT REGISTRATION FORM

Upon submission of the form you will receieve a Parental Consent form to be filled and signed by parent/guardian if you are under 18. Please return to your church youth leader or send back to miracleyouth.mcci@gmail.com