Keep Watch with Me: An Advent Retreat

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Please fill out the form to reserve a place for this retreat.

Name *

Full address (including city, state, and zip) *

Email address *

Phone number *

Gender identity *

Racial/ethnic identity? *

Age? (Must be over 18) *

Pronouns *

he/his/him

she/her/hers

they/their/theirs

Other:

Dietary needs (not preferences) *

Physical Needs/Assistance *

Are you able to drive yourself to the retreat or do you have access to a ride? *

Yes

The standard rate for this retreat is $295. Sliding scale rates are available from $250-$350 for those who cannot pay the standard rate or who can afford to pay more to help those who must pay less. Please indicate below what you can afford to pay for this retreat. *

$295—Standard rate

$250 - Discounted rate

$275 - Discounted rate

$325 - Generosity rate

$350 - Generosity rate

None of the above—need a larger scholarship.

Other:

Would you be able to pay the full price of your ticket at once, or would you need a payment installment plan? *

All at once

Installment plan

I can't pay anything.

How did you hear about this retreat? *

What are you most looking forward to about the retreat?

Any remaining comments or questions?

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