Women’s Retreat
Registration for Women's Fall Retreat, Oct 1-3, 2010
Location: Ayres Hotel & Suites, Costa Mesa, California
Registration Deadline September 1, 2010
Price includes Full American Breakfast on Saturday and Sunday mornings plus a Saturday Lunch Banquet. All rooms are equipped with refrigerators.
Name:
Address:
Phone; Home, Cell:
City, State & Zip Code
Please select how many people you wish to share a room with:
4 people per room
3 people per room
2 people per room
none, room by myself
Payment Options
Will pay in Offering or in Person
1 person per room (Add $140.00)
2 people per room (Add $156.00)
3 people per room (Add $172.00)
4 people per room (Add $256.00)
I have already chosen my roommates. (If yes, please list their names below. If no, roommates will be prayerfully chosen for you.)
Yes
No
Names of those you wish to room with:
To better serve you, please complete the questions below:
1. Medical Condition, describe:
Do you need a ride to the retreat OR can you take additional passengers?
Yes, I need a ride.
No, I don't need a ride
Yes, I can take additional passengers
If you are able to take additional passengers, how many can you take?
Please give us an EMERGENCY CONTACT Name & Phone:
Your Email Address
*
Base Price
$
Modifications
$
Total
$
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