2019 Embrace Fall Retreat Registration Form
// DATE
Friday, Sept. 27 - Sunday, Sept. 29

// LOCATION
4-H Educational & Conference Center
600 4h Center Dr, Front Royal, VA 22630
Directions: https://goo.gl/maps/j8DJvtgU7JxhorYK9
Website: http://www.nova4h.com/

// FEES
Payment must be received by the due date

Sunday, August 18 - $85/person
Sunday, September 8 - $95/person

Children - $15/child

// PAYMENT OPTIONS
Cash
Check (please make it out to "Embrace Ministry")
Venmo (https://venmo.com/embrace-ministry)

Please give cash and check payments to Shelley or Allan
Email address *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Emergency Contact Phone Number (Name and Phone Number) *
Your answer
Any food allergies (Please list below)?
Your answer
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