"A Work in Progress"
October 13 - 15, 2017
Tenth Annual Bethel Church Fall Retreat
Camp Adams, Molalla, Oregon
Names of Family Members Attending
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Ages of children Attending
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Home Phone
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Cell Phone
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Email
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Accommodation Preferences
Sharing Preference: If you wish to share a bunk, please tell us with whom you wish to share your 5-bunk cabin.
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Arrival Time
Meals
Friday evening meal, 5:30 pm - 8 pm, is a potluck. Bring a dish to share! Saturday breakfast, lunch and dinner, Sunday breakfast and lunch are provided by Camp Adams.
Special Dietary Needs
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I/we can help with
Payment
Payment
Cost includes housing Friday & Saturday. Also includes Saturday meals (breakfast/lunch/dinner) and Sunday breakfast & lunch.

Mail checks to Bethel Congregational UCC - PO Box 219, White Salmon WA 98672, or drop off at church on Sunday.

Total Registration Fee owed:
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To donate to the scholarship fund:
Camp Adams charges $71 per camper. If you can donate toward a scholarship, please indicate the amount of your donation below
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To request a scholarship:
Please do not let finances or transportation be an obstacle to your attending this event! If you want a scholarship, please tell us how much of the full registration you can afford to pay in the space below.
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To request transportation:
Please do not let transportation be the reason you don't attend. If you need a ride, please tell us how many seats (and seat belts) you will need below. Carpooling is efficient and fun - feel free to volunteer a seat or two in your vehicle, too!
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