Breathe FBCK Women's Retreat
Register for the Breathe FBCK Women's Retreat at the Solomon Center in Loranger, LA on January 12-13, 2018.
Full name *
Your answer
Address *
Including City, State, Zip
Your answer
Phone Number *
Best number for us to reach you
Your answer
Email Address *
Your answer
I am interested in being a discussion leader in a breakout session. *
I am interested in being a hostess in a breakout group. *
Would you be willing to donate to those in need of a scholarship to attend this event? *
If yes, how much?
Your answer
Roommate Preference(s)--one or two (names) *
Your answer
Emergency Contact *
Name and phone number of someone we should contact in case of an emergency
Your answer
Allergies or Dietary Needs *
Your answer
T-shirt size *
Payment Info.
Registration will not be complete until we receive this form and your complete payment. If paying by check, make check payable to First Baptist Church of Kenner.

Cost is $99. Non-refundable deposit of $25 due by June 4, 2017.

For easy, secure online payments, go to our website at, click "give" (top right hand corner), and note that it is for the Breathe Women's Retreat.

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