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
City, State, Zip
Prior Cabin Rate. Limited # avail. Must have stayed in cabin last year to qualify - $150 ($125 if registered/paid before 12/28/18) Indicate Roommate preference below.
Regular Hotel - Triple occupancy - $250 ($225 if registered/paid before 12/28) Indicate Roommate preference below.
Regular Hotel - Double occupancy - $270 ($245 if registered/paid before 12/28) Indicate Roommate preference below.
Regular Hotel - Single occupancy - $300 ($275 if registered/paid before 12/18)
Indicate Roommate's name(s) or No Preference.
Option - Pizza on Friday Night ($7.00)
I am in need of a ride.
$100 Deposit due when registering. Balance due by Jan. 7th. (Unless paying in full early for discount.)
I will pay on-line. (Please enter the amount under "Men's Retreat".)
I will pay by check. (Please mark "Men's Retreat" in Memo line.)
I will pay in cash. (Please include a note with your name and "Men's Retreat".)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service