Church-Wide Retreat- 2019

Family Name*

Frist Time Attending

YesNo

Phone Number*

Permission to Text?

YesNo

Email*

Family Members Attending
Please list all family members attending, including current grade for children/youth. All youth not with family must have an adult chaperone and be included on that family's information.

Name*

AdultChild

Grade

Name

AdultChild

Grade

Name

AdultChild

Grade

Name

AdultChild

Grade

Name

AdultChild

Grade

Name

AdultChild

Grade

If you desire to be placed near another family (or for youth to share a room), list below:

Please complete all categories (that apply). Space is first come first serve.

Registration Fee *

	Number of People
$16.50 Per Person

I am interested in only attending the Saturday Speaker Sessions (9:00am - Noon & 4:00-6:00pm) with the option to purchase meals. I understand this would not include lodging. You will be contacted with more information and pricing. *Registration fee still applies.

Yes

Accommodation Pricing - Linwood Wing (Private Bathroom)

	Number of Rooms
Single Occupancy $58.00 Per Night
Double Occupancy $71.00 Per Night

Linwood Rooms are set up to accommodate two adults. Occupants or families have the option to pay an additional $7.00 per Person to adapt the room to sleep additional persons. Extra occupants are required to provide their own sleeping accommodations (air mattress/sheets/pillow). Please indicate below.

Additional Charges for Accomodations

	Number of People
$7.00 Per Person

Accommodation Pricing - Oakwood Wing (Dorm Style)

	Number of Rooms
Double Occupancy $59.00 Per Night
Triple Occupancy $67.50 Per Night

Campsite (RV or Tent)

	Number of Nights
$20.00 Per Night

Accommodation Total

Total in Dollars

Kids Meals (Ages 4 - 10)

	Number of Children
Saturday (Lunch & Dinner) Sunday (Breakfast) $15.00 Per Child

Adult Meals (11 Years & Older)

	Number of People
Saturday (Lunch & Dinner) Sunday (Breakfast) $28.00 Per Person

Meal Total

Total in Dollars

The Accommodation & Meal total below is subject to change depending on availability. Registration fee ONLY is due upon submission. You will receive a final invoice with remainder owed. Email Mici Kuba (MKuba@FUMCPensacola.com) for more information.

Accommodation & Meal Total

Not Including Registration Fee

Registration Fee Total (Due Upon Submission)

Total in Dollars

Form of Payment*

CashCheckCredit/Debit Card (Online Only)

Please Note:
Your can pay online via debit or credit card at FUMCPensacola.com. When paying, please use the "Other" category and indicate "Blue Lake 2019" in the required blank. You may also mail a check, payable to FUMC Pensacola to 6 East Wright Street, Pensacola, Florida 32501 or submit a cash payment at the Front Office.

Questions or Concerns? Please type below.