Eucharist Fall Retreat 2017 Registration Form
Mission Springs Camp & Conference Center // Friday evening - Sunday noon (November 10 - 12)
Full Name(s) of all individuals in your party. Indicate if any are children (and their age). *
Your answer
Email address of adults *
Your answer
Phone number *
Your answer
Will you need a ride? *
If you are driving, please tell us how many seats you have available (if any) and where, geographically, you will be coming from on Friday.
Your answer
Please list any special dietary restrictions?
Your answer
Anything else we should know (or questions you have)?
Your answer
Please calculate your own registration cost and indicate how you are paying.

- Adult Early Bird Rate (through Oct 1) - $150
- Standard Adult Rate (through Oct 29) - $175
- Early Bird Child Rate - $50
- Standard Child Rate - $60
- Children Ages 0 - 3 are free!
- Full Time College Student Rate - $100

If money is a barrier to your participation, we will find a way to make this work for you.

How are you paying? Registration is not complete until we receive your payment.
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