WESLEY Fall Retreat 2019
Fill out the form below to register for Fall Retreat
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Email *
Your answer
What year are you? *
Will you be at least 18 years of age before September 28th? *
Do you have any medical conditions we need to know about? (Only conditions that could present a medical emergency. If you prefer, you can simply email Thomas at thomas@utawesley.org)
Your answer
Carpool going down? *
If "no" - when will you be leaving UTA?
Your answer
Carpool coming back? *
If "no" - when will you be leaving Glen Rose?
Your answer
WESLEY will reimburse drivers if you take at least 2-3 other people. Are you willing to drive for carpool? You must have a reliable car, a valid license, insurance, and a willingness to obey all traffic laws. *
PAYMENT: The retreat is $30 which must be paid online or in person. You must pay before Tuesday, September 24th. *
SIGNATURE: Please type your name below to confirm the following statement: "I am registering for Fall Retreat. I will pay the $30 fee. If I can't go I'll cancel. I will not hold UTA Wesley or Glen Lake Camp and Retreat Center liable for any injuries resulting in my participation in Fall Retreat." *
Your answer
WAIVER: Please type your name below to confirm the following statement: "I wish to participate in the Wesley Fall Retreat offered during the dates above. I understand there are risks involved and will not hold the UTA Wesley responsible for any loss of property or personal injury associated with this trip. I understand that Wesley is a Christian organization and agree to act for the duration fo the trip according to Christian standards of conduct in regards to (but not limited to) sexuality, speech, interpersonal relationships, and obedience to the law." *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of UTA Wesley Foundation. Report Abuse