Springhouse Family Fun Retreat 2021 Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

NAME *

HOME ADDRESS *

PHONE *

EMAIL *

CHOOSE ONE OPTION *

*OPTION A- Lodge (Hotel style, with two queen beds) INDIVIDUALS $75 EARLY REGISTRATION + $210.00 / *** All Inclusive FAMILIES $150 EARLY REGISTRATION + $210.00 / All Inclusive AFTER MAY 16th INDIVIDUALS $100 LATE REGISTRATION + $210.00 / All Inclusive FAMILIES $175 LATE REGISTRATION + $210.00 / All Inclusive - *OPTION B- Bunk style, shared facilities. Must provide bedding) INDIVIDUALS $75 EARLY REGISTRATION + $25 / *** All Inclusive FAMILIES $150 EARLY REGISTRATION + $25 / All Inclusive AFTER MAY 16th INDIVIDUALS $100 LATE REGISTRATION + $25 / All Inclusive FAMILIES $175 LATE REGISTRATION + $25 / All Inclusive

Option A - Lodge (Hotel style, with two queen beds)

Option B - Dormitory (Bunk style, this option provides bunks and shared facilities - those choosing this option will need to bring their own bedding, i.e, sheets, pillows, blankets, sleeping bags, etc...)

NUMBER OF ROOMS REQUESTED (For Option A, Hotel Style Only)

NUMBER OF BEDS REQUESTED (For Option B, Bunk Style Only)

HOW MANY ARE ATTENDING FROM YOUR FAMILY?

PLEASE PROVIDE THE FOLLOWING INFORMATION FOR EVERYONE IN YOUR PARTY: Name, Age, Date of Birth, and T-Shirt Size

DO YOU, OR ANY MEMBER OF YOUR GROUP HAVE LIFE-THREATENING FOOD ALLERGIES OR MEDICAL ISSUES THAT MAY BE PERTINENT TO YOUR STAY?

YES

Clear selection

IF YES, PLEASE EXPLAIN

IMPORTANT NOTES

All individuals under the age of 18 must be accompanied by a parent.
*** All Inclusive denotes food, lodging, and use of grounds and facilities

If you have any questions, please contact Apryl Davis, springhouse.church@springhousesmyrna.com

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Springhouse Worship and Arts Center. Report Abuse

Forms