2023 CoDA Texas Retreat & Conference Registration
Join us on a recovery journey of "Finding Direction: One Step at a Time":
Ā Ā  Ā  šŸ“…Ā  September 29th - October 1st
Ā  Ā  Ā  šŸ“ Ā  Camp Lone StarĀ in La Grange, TXĀ MAP
Ā  Ā  Ā  šŸ’°Ā  Prices (closes 9/22):Ā $250Ā 3-DayĀ |Ā $125Ā 1-DayĀ 
Ā  Ā  Ā  Ā  Ā  Ā  Ā Scholarship InformationĀ HERE
Ā  Ā  Ā Ā šŸ‘‰Ā Click to view the retreatĀ FLYERĀ & tentativeĀ AGENDA
Ā  Ā  Ā  šŸ‘ļø Preview *new* Payment Options at CoDA Texas Square
      😃 Workshop & Speaker SERVICE opportunities available
Please complete the form below & follow the payment link to complete your registration.
Sign in to Google to save your progress. Learn more
NAME (First & Last Initial Only): *
EMAIL (Shareable): *
PHONE (Text): *
CoDA BIRTHDAYĀ (Month & Year):
CoDA HOME GROUP: *
If OTHER for Home Group, please add your group info here:
RETREAT REGISTRATION (Select One Option):
*
EMERGENCY CONTACT: Please provide the first name & contact number for the best person to reach incase of an emergency below.
*
DIETARY NEEDS: Please let us know if you have any special dietary needs that we should pass on to the camp kitchen for meals. *If NONE, please SKIP & leave blank.
LODGING INFO & ROOMMATE REQUEST: All retreat lodging is "first come, first serve" and in rooms of 3-6 occupants. If you would like to room with someone specific, please state their name(s) here and we will try to accommodate your request. Please note there are no guarantees - check-in starts at 3pm on Friday, September 29th.
CoDA TEXAS RETREAT LIST:Ā I give permission for the following contact details to be included in the CoDA Texas Retreat ListĀ shared with retreat participants. (Select All That Apply): *
Captionless Image
Required
PICTURE [OPTIONAL]: Help everyone put a name with a face! Email, upload, or take at check-in a recent image of yourself (only you, please). *
FAVORITE RECOVERY QUOTE(s) or TOOL(s) [OPTIONAL]: Share your experience, strength, & hope here!
RETREAT T-SHIRT (PRE-ORDER ONLY - CLOSES 9/1): There will be an optional t-shirt (preview below - heather green - unisex) available for $30 via pre-order only by September 1st. Please select your choice below & include in payment step: *
Captionless Image
PAYMENT STEP: CLICK HEREĀ to make your payment by selecting a payment plan option on Square site. Please select the your payment statusĀ below after following the link & steps:
*
INTERESTED IN LEADING A WORKSHOP OR SPEAKING?Ā We are excited to announce that this year's retreat will feature workshop breakout sessions (see image below) and open to presenters in all stages in their recovery. For this to work, we will needĀ  ≄ 12 service volunteers to share their experience, strength, & hope.Ā Please express your interest & a committee member will reach out via email soon!
*
Captionless Image
SILENT AUCTION DONATIONS:Ā Would you like to donate an item &/or service for our Silent Auction to help with Retreat Expenses & CoDA Texas? Please list the item(s) with a brief description below, if unsure please type YES to participate & someone will reach out to you in early September to confirm donation.
OPTIONAL: Please include any comments &/or questions for the Planning Committee here:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy