Cherith Retreat Registration

Your Name (Pastor)*

First NameLast Name

Your church/ministry name and location:*

How many years have you been in ministry?*

Tell us a little about yourself: *

Tell us a little about your goals for your getaway: *

Please list any other family members who you plan on bringing:

	Name	Age of Children
Wife
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Email*

example@example.com

What date would you like to arrive?*

See picture above. Available dates are marked in white.

Lodging*

Treehouse (Modular style home)Bring your own Camper or RV

Any special accommodations needed or notes you need to add:

How did you hear about this opportunity?*

Once your application has been accepted and we've confirmed your reservation, Trail Ridge requires that a $50.00 Deposit Fee be charged upon secured booking for a Cherith Retreat. This deposit will be refunded after check-out, provided no incidentals have been incurred.