2024 Weekend Retreat Registration Form

Thank you for your interest in joining us February 23-25 for our wellness and worship retreat! We ask that you fill out the registration form below so that we can make sure we take excellent care of you!

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

EMERGENCY CONTACT

First Name

Last Name

Relationship

Emergency Contact's Number

Any medical conditions or allergies we should be aware of?

Dietary restrictions or preferences?

Are you interested in carpooling?

Do you require special assistance or accommodations? (Please specify)

Any specific prayer requests or topics you'd like addressed during the retreat?

Any other comments or special requests?

Liability Waiver

I understand that participation in this retreat involves certain risks. I hereby release Reign Awakened Women's Ministry and its organizers from any liability for personal injury, loss, or damage to personal property.

Reign Awakened Women’s Ministry

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FAITH BASED ONLINE WOMEN'S MINISTRY