Teen Girls' Day Retreat Registration Form
Event Timing: August 26-30, 2019,  9am to 4:30 pm
Event Address: Carp Ridge Ecowellness Centre, 4596 Carp Rd, Carp, ON, K0A1L0
Contact us at : blueheronschoolofdiscovery.ca,blueheronschoolofdiscovery@gmail.com, facebook.com/blueheronschoolofdiscovery/,  613-804-3395
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Email *
Student Name, Last, first *
Date of Birth ? *
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DD
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How did you hear about our Retreat ? *
Age (by Aug 26, 2019) *
Address *
City, Province *
Postal Code *
Parent/Guardian- full name(s) *
Daytime Phone number *
Secondary Phone number *
Primary email address *
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