Nov. 16th Navigating Loss Grief Retreat
Retreat is free (and sponsored by the Memorial Fund of Winter Park Presbyterian Church). A $12 donation to the church is requested to cover the cost of lunch.

The retreat will begin in the morning and continue through the afternoon.
Participant's Name *
Your answer
Phone Number *
Your answer
E-mail Address *
Your answer
Church Affiliation
This question is optional and may be skipped if you prefer.
Sandwich Selection *
Quality Boxed Sandwiches will be ordered from a wonderful local caterer. Offerings may vary at time of order, but in order to get an idea of which sandwiches we should order, please place a request below - which we will attempt to honor.
Does this person have any dietary, allergy, or medical needs that we should know about? *
If yes, please describe in next question.
Please tell us anything else we need to know about this participant?
Your answer
The questions below are requested by the retreat leader and facilitator, Donna Marie Todd
Please describe your loss.
Your answer
What is the date of your loss?
MM
/
DD
/
YYYY
I have / have not received bereavement counseling.
I understand that this retreat is not bereavement counseling and that it is not intended to take the place of personal bereavement counseling. *
Required
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