Early 2019 Women's Retreat Registration

Early 2019 Women's Retreat Registration

Please pay below or bring or mail payment to EBC
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Special needs for meals
Can you climb stairs?

YesNo
Are you bringing an infant?

YesNo
Notes
Transportation (info of those needing rides and those who can take others will be shared so you can coordinate rides with each other)

I already have my ride situation figured outI need a ride (note what time you can leave)I can take others in my vehicle (note how many and what time you are leaving)
Notes
Zipline! FULL

This year we have the opportunity to do the zipline on Saturday! (Big swing will also still happen at a different time, so you can do both.) If you want to do the zipline, it will be an additional $15. We are limited to 20 spots so the first 20 to register for this AND pay will get the spots! (If for some reason we don't get 20, you will be reimbursed the $15.)
I would like dinner at the retreat center on Friday night ($8.00). Deadline to register AND pay for dinner is September 15.*

Yes I want dinner at the retreat center (MUST be able to be there by 5:30pm Friday)I will do dinner on my own
Scholarships

Some PARTIAL scholarships are available for the retreat cost only (you will still need to pay the full amount for Friday night dinner). Please mark below if you need one. Please note below how much you are able to pay. Someone from the Women's Retreat Team will contact you.
I need a Scholarship

YesNo
How much of the $99 cost can you pay? (No scholarships are available for dinner.)
CASH OR CHECK PAYMENT. Bring or mail payment to EBC (Evergreen Bible Church, 9600 E. Mill Plain Blvd., Vancouver, WA 98664). If doing Dinner and/or Zipline, those must be paid for immediately.

Retreat ($99 if registered by September 15. Price goes up to $109 after September 15.)Friday Night Dinner ($8.00)

My Products

Retreat$99.00

Friday Night Dinner$8.00

Total $0.00

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