Discipleship Leaders Retreat - Participant Registration
Participant Registration
Refund Policy
A 50% refund can be given for cancellations before March 22, 2024 and a 25% refund for cancellations before April 12, 2024.
After April 12, 2024 no refunds can be given.
Church Information
Please select the city first to aid in finding the correct church.
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Church City
Church Name
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Non-Affiliated Church
Church Name
Church City
City ID
Church ID
Today
Registration Information
All registrations include meals.
Registration Type
Retreat with Single Lodging ($340)
Includes 2 breakfasts, 2 dinners, materials, facility use, and lodging with 1 bed. Tuesday lunch on your own
Retreat with Double Lodging ($220)
Includes 2 breakfasts, 2 dinners, materials, facility use, and lodging with 2 bed. Tuesday lunch on your own
Retreat Only ($190)
Includes 2 breakfasts, 2 dinners, materials, facility use for 1 person. Lodging not included. Tuesday lunch on your own.
Will your spouse be attending?
Yes ($52)
No
Amount Due
$
Attendee Information
First Name
Last Name
Email
Cell Phone
What is your title at church?
Please note any dietary restrictions for this person
Do you have a roommate preference?
Yes
No
Roommate Full Name
Spouse Information
Spouse's First Name
Spouse's Last Name
Spouse's Email
Spouse's Dietary Needs
Payment
Discount Code
Payment Type
Credit Card (3% processing fee applies)
eCheck
Registration Summary
Subtotal
$
Total Discounts Applied
$
Total before card fees
$
Credit Card Fees*
$
3% added for credit card processing
x
Total Amount Due
$
Credit Card Information
Name on Credit Card
Credit Card Number
Credit Card Code
(Card Verification Value / CVV / CSV)
Credit Card Expiration Month
Credit Card Expiration Year
Credit Card Type
Please select...
Visa
Mastercard
Amex
Discover
eCheck Information
Bank Name
Name of Account Holder
Bank Routing Number
Bank Account Number
Account Type
Checking
Savings
Business Checking
Customer Billing Information
First Name
Last Name
Email
Street Address
City
State
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Postal Code
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