IBC Ladies Retreat
Fill out the form below to attend the IBC Ladies Retreat, January 18-19, 2019. Please be sure to follow the link at the bottom to pay the registration fee. Shirt registration deadline January 2nd, 2019; deadline for no shirt ordered will be January 11, 2019.
Email address *
Full Name: *
Your answer
Address: *
Your answer
Cell Phone Number: *
Your answer
Can we send you text messages? *
Select one: *
If you choose to purchase a sweatshirt, what size do you need?
Please indicate transportation to Falls Creek: (Departure time: 5:30pm, Jan 18th) *
Special Concerns: (Including request for 1st floor room)
Your answer
Payment Method
Please let us know how you will pay.
Will you pay online or in the office? *
Please fill out all emergency contact information below:
Emergency Contact Name: *
Your answer
Relationship: *
Your answer
Emergency Contact Phone: *
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Immanuel Baptist Church. Report Abuse - Terms of Service