Autumn Day Retreat
Date: September 26, 2015

Time: 9 am to 8 pm

Location: Atonement Lutheran Church, 9948 Metcalf Ave, Overland Park, KS

Price without Meals: $15
Price with Lunch Only: $25
Price with Supper Only: $20
Price with Lunch and Supper: $30

First Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number
Your answer
Last Name *
Your answer
Would you like a boxed lunch? *
Adds $10
Would you like pizza for supper? *
Adds $5
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service