2019 Men's Retreat ~ 1/18/19-1/20/19 ~ Black Rock Retreat Center
Please fill out and submit. Questions? Contact Alan Hash @ 856-498-6965 or jamesalanhash@gmail.com.
Name *
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Street Address *
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City, State, Zip *
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Home Phone *
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Cell Phone
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Email
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Accommodations *
Roommate Preference
Indicate Roommate's name(s) or No Preference.
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Option - Pizza on Friday Night ($7.00) *
I am in need of a ride. *
Payment *
$100 Deposit due when registering. Balance due by Jan. 7th. (Unless paying in full early for discount.)
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