Women's Retreat 2022 Registration

First Name

Last Name

Email Address

Cell Phone

Address 1

Address 2

City

State

Zip Code

Emergeny Contact Name

Emergeny Contact Phone

List Any Food Allergies

Church or Group Name

Your Pastor's Wife or Women's Ministry Leader's Name

Which session will you be attending?

September 30 - October 2 is currently full. If you would like to sign up for a wait list, please email debbie@vcnsw.org

September 30 - October 2October 7 - October 9

Will you be staying on campus?

To sign up for Program & Meals Only (sleeping off-site), choose "No".

YesNo

Will you require mobility assistance?YesNo

If you are purchasing a t-shirt, please indicate your size – $20.00SmallMediumLargeXL2XL3XLNone

Please indicate which activities/times in which you'd like to participate:

Craft @ Hungry Bear – $5.00Saturday, 1:50pmSaturday, 2:10pmSaturday, 2:50pmSaturday, 3:10pmSaturday, 3:30pmNone

Painting Craft @ Marapai – $5.00Saturday, 1:00pmSaturday, 3:00pmNone

Bingo @ Chapel – $5.00Saturday, 8:30pmNone

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