Midtown Women's Retreat 2018 Registration
Lake Gaston | Friday, October 26 - Sunday, October 28
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
How did you hear about the Women's Retreat?
Midtown Website
Midtown Bulletin
Midtown Update
Friend
Social Media
Other
Roommate Preference(s):
First & Last Name(s)
I am willing to sleep in the following bed accommodations (we will do our best to accommodate bed preferences):
*
King bed with someone else
Twin bunk alone
Queen bed with someone else
Happy to sleep anywhere!
Do you have any dietary restrictions?
Vegetarian
Vegan
Gluten Free
Other
Would you like to purchase a long-sleeve 2018 Women's Retreat t-shirt similar to the above for $18? (If yes, please ensure the $18 is added to your total payment at the bottom of this page.)
Yes
No
T-Shirt Size (Men's Sizing):
XS
M
S
L
XL
Other
Payment
*
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( X )
USD
$103 Prior to 9/23 ($121 with t-shirt) | $128 Post 9/23 | $33 Saturday Day Only
Credit Card
Submit
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