Kairos 2020 Sign-Up
Please fill out this form by Sunday 1/26 if youd would like to attend the 2020 Kairos Retreat taking place January 31st - February 2nd!
First and Last Name *
Your answer
RIT Email *
Your answer
Cell Phone Number *
Your answer
Emergency Contact #1 Name *
Your answer
Emergency Contact #1 Phone Number *
Your answer
Emergency Contact #2 Name *
Your answer
Emergency Contact #2 Phone Number *
Your answer
Do you have any medical needs we should know about?
Your answer
Please list any medications you are on here. If there is an emergency, this information will be accessible in case it's needed.
Your answer
Do you have any dietary restrictions?
Please explain specifics for dietary needs/allergies, and how we can support
Your answer
The retreat cost is $20 which includes the program/registration and food. How would you like to pay for this? *
If you choose cash or check, please bring to Kim's office. If you choose Venmo, you can do that at any time and we will document the payment. For Venmo and check, please be sure to put "Kairos Retreat" on the memo line.
Can you be a driver? *
If you choose cash or check, please bring to Kim's office. If you choose Venmo, you can do that at any time and we will document the payment. For Venmo and check, please be sure to put "Kairos Retreat" on the memo line.
If so, how many people can you fit besides yourself?
Your answer
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