Engage Retreat Registration
Dates: July 9-13
Total Cost: $200 ($100 Non-Refundable Deposit)
Location: Ponderosa Camp and Retreat Center
Trip Leader: Pastor Richard Eng

Asylum Student Ministries
Name *
Grade Completed (as of May 2020) *
Gender *
Email *
Address *
Phone Number *
Parent(s) Names *
Parent (s) Email *
Emergency Contact Name and Number *
Name One Desired Roommate *
T-Shirt Size *
Dietary restrictions *
Name Any Medical Conditions/Allergies That Leaders Should Know *
I understand that my registration is not complete until I pay the $100 non-refundable deposit. *
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