Application: Pastor & Spouse Retreat: Happy & Healthy Marriage in Ministry
   
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Pastor & Spouse Retreat:  Emotionally Healthy Marriage in Ministry
July 15, 2020 (5pm registration) - July 18, 2020 (11am farewell & benediction)  

For more info, see:  https://www.shepherdheartconsulting.com/retreats/

The following is an application to attend Shepherd Heart's Pastor & Spouse Retreat in Northern Arizona:  "Happy & Healthy Marriage in Ministry."  Please fill this form out in its entirety and follow payment instructions below.  Completed applications must be approved by Shepherd Heart for attendance. (Kindly await notice of approval before booking travel arrangements.)
Full Name of Pastor *
Full Name of Spouse *
Contact information for both: (cell phones, home address, emails) *
Your congregation (name, address, phone number) *
Emergency Contact: (Your relationship to contact person, their phone, address & email) *
Pastor:  Please list 3 of the biggest strengths of your marriage. *
Pastor:  Please list 3 of the biggest challenges that ministry has presented to your marriage. *
Pastor: Satisfaction Level in current ministry setting *
Extremely Dissatisfied
Extremely Satisfied
Spouse:  Please list 3 of the biggest strengths of your marriage. *
Spouse:  Please list 3 of the biggest challenges that ministry has presented to your marriage. *
Spouse: Satisfaction Level in current ministry setting *
Extremely Dissatisfied
Extremely Satisfied
If ever, when was the last time there was an episode of domestic violence, specifically between you and your spouse? *
Personal Reference #1 (Full Name, phone, email) *
Personal Reference #2 (Full Name, phone, email) *
Personal Reference #3 (Full Name, phone, email) *
Pastor:  Do you give permission for Shepherd Heart to contact your personal references? *
Spouse:  Do you give permission for Shepherd Heart to contact your personal references? *
Do you or your spouse have any strict dietary needs or food allergies?  Please Describe. *
Do you or your spouse smoke?  Please be aware that this retreat is entirely smoke-free. *
Are you and your spouse in good health?   *
Do either of you have any physical or medical limitations that could foreseeably impact you on the retreat?  (The retreat is in a beautiful, mountainous area, with an approx. elevation of 6000 ft.)   *
Do you have a promo code?  Enter it here.
Payment:
Full payment: $650/couple

Mail check to (payable to "Shepherd Heart"):  
Shepherd Heart
595 E. Colorado Blvd., Ste. 409,
Pasadena, California 91101


Pay via PayPal: (couple fee +$15 convenience fee)
https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=EV4H9YZMMYA6G


Refund schedules are as follows:  
75% refund is available for cancellations on or before April 15;
50% refund is available for cancellations on or before May 15;
25% refund is available for cancellation on before June 15.
No refunds are available for cancellations after June 15.

You provide your own transportation to and from the retreat site, as well as to recreational activities.
 
Travel Instructions & Directions:
The retreat is in Munds Park, Arizona, nestled in the ponderosa pines between Sedona & Flagstaff- which makes it particularly picturesque.  The exact address is given upon approved application and full payment of $650/couple.  (Refund schedules are as follows:  A 75% refund is available for cancellations on or before April 15; a 50% refund is available for cancellations on or before May 15, a 25% refund is available for cancellation on before June 15. No refunds are available for cancellations after June 15.)  Registration begins at 5pm on Wednesday, July 15.  You will be required to provide your own transportation to the retreat site, and to any points of recreation, such as Flagstaff, the Grand Canyon, Sedona, or the Tlaquepaque Arts Village.  (Fees associated with such excursions - shopping, and/or dining out, etc. -  are not included in the retreat cost, of course, but are fun "extras" to choose from during your "play times" over the week.)  

Flying:  There is a major airport in Phoenix (Sky Harbor) with direct flights from many departure cities across the country.  There are also two smaller regional airports (Sedona & Flagstaff).  See maps below.  Many people find Sky Harbor (Phoenix) to be the easiest airport of the three, due to greater availability and flexibility in daily arrivals and departures. For this reason, Sky Harbor (Phoenix) is the recommended destination for air travel.  (Even though it's *really warm* in Phoenix in July, you'll be amazed at what a difference an elevation of 7000ft can make!)  Rental cars for the weekend should be easy to come by, especially from Sky Harbor - but reservations are always recommended.  (Pro-tip:  Especially for those flying great distances, travel insurance to compensate you for any travel inconveniences, like flight delays, cancellation, etc, is often a wise choice.)  

Driving Instructions:  From the North:  The city of Flagstaff is at the junction of I-17 and I-40.  Munds Park is 21 miles South of Flagstaff on I-17, exit 322:  Pinewood Blvd.

From the South:  Munds Park is 126 miles NORTH (and many degrees cooler!) from Phoenix on the I-17.  

For those who wish to extend their stay in the area after the retreat has ended, there are several lovely resorts available in and around the Flagstaff & Sedona areas.  Again, reserving ahead is wise!
Phoenix (Sky Harbor airport) to Munds Park (recommended)
Sedona Airport to Munds Park, AZ
Flagstaff airport to Munds Park
*Liability Waiver - I agree and acknowledge that I am participating in the Shepherd Heart retreat, on my own accord and at my own risk. I give this acknowledgement freely and knowingly and represent and warrant to you that I am physically and mentally fit to do so. I agree that I am able to participate in retreat activities and do hereby assume responsibility for my own well-being. I am fully aware that possible physical injury and even property loss might occur to me as a result of my participation in activities such as, but not limited to recreation, servant projects, field trips, traffic issues, lodging safety, city or wilderness dangers, altitude sickness, exposure to illness, theft, et al. I agree to assume full risk, including risk which is not specifically foreseeable, of any injuries including death, damages or loss regardless of severity which I may sustain as a result of participating in any and all activities connected with or associated with Shepherd Heart, for any reason or by any cause including through the negligence of Shepherd Heart and its agents. In consideration of the right to participate in the Shepherd Heart retreat, I hereby waive any and all rights or claims that I may have as a result of participation in the retreat against Shepherd Heart and its associates that might assist in instructing and conducting these activities, I hereby fully release and discharge them from any and all claims resulting from injuries, including death, damages or loss, which may accrue to me or my heirs arising out of or in any way connected with my participation in the Shepherd Heart retreat. I also agree that I will reimburse Shepherd Heart for any medical and other expenses incurred on my behalf. *
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