2018 CCCTO Women’s Retreat Registration
WHEN: November 9 -11 (Friday- Sunday)
WHERE: Residence Inn Oxnard River Ridge at 2101 West Vineyard Ave., Oxnard, California 93036
COST: Early Bird $205 (by 9/16), Regular $225 (by 10/21)
Please complete one form per retreat attendee.
Registration fee includes two nights hotel suite stay and four meals (Saturday - Breakfast, Lunch, Dinner and Sunday - Breakfast)
Chinese Name (Optional)
56 and over
City/State/ Zip Code
Phone Number (where you can be reached during retreat)
Emergency Contact Name
Emergency Contact Phone #
Relationship to Emergency Contact
Church You Currently Attend
None at this time
If other please specify full church name:
Roommate Preference - Please provide 2 names. Skip if no preference.
Are you willing to sleep on a sofa bed?
Do you have physical difficulties using stairs? (The hotel does not have an elevator and we have suites on the 2nd floor.)
Would you like to volunteer in other ways during the retreat?
Preferred Language for Small Group Arrangement
If other please specify:
Would you like to be a small group leader?
What language do you prefer to lead in?
Food Selection for Saturday's Plated Dinner - All entrees include Caesar Salad, seasonal vegetables, garlic mashed potatoes and dessert.
Options: (1) TRI TIP – Thinly sliced topped w/ garlic sauce (2) SALMON - Pan seared/baked salmon fillet w/ lemon caper sauce (3) PORTOBELLO MUSHROOM - vegan & gluten free
Dinner options: (select one)
Special Dietary Requests:
Need a ride
Can drive others (See next question.)
If you can drive others how many additional seats are available in your car?
Pay by Check
Early Bird (by 9/16) (Add $205.00)
Regular (by 10/21) (Add $225.00)
Partial Payment by Request (enter amount below)
Please make checks payable to CCCTO. Memo: Women's Retreat.
For any scholarship requests or additional questions please feel free to email us at email@example.com.
Partial Payment or Additional Donation (please enter amount)
Your Email Address
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