Registration Form
Dates: November 17th - 19th, 2017
Address: 1226 Silver Spring Rd., Holtwood, PA 17532
Contact us at 267-945-4989, or
Young Adults Retreat 2017
Name and Last-name *
Your answer
Age *
Your answer
Phone number *
Your answer
Email *
Your answer
In case of emergency contact: *
Your answer
Emergency contact number *
Your answer
I understand that I will have to pay $35 upon registration and $40 before November 15th, 2017 *
Cash or check payable to New Life Church Philadelphia
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