WINTER RETREAT SIGN UP
A weekend for young adults looking to unplug from the complexities of city life.
We want to get out to a place of retreat and into the outdoors to search our busy souls and restore a clear view of the things that really matter.

“I have come that they may have life, and have it to the full…” (Jesus) Hungry for more? So are we…

STEPS:
1. Complete this form
2. Click PUSHPAY link to complete registration payment (select FUND: UNPLUG Winter Retreat Registration in dropdown menu)
3. Invite somebody!
4. Join the UNPLUG Winter Retreat Facebook event
5. Get yourself ready for an amazing weekend
YOUR INFO
First name *
Your answer
Last name *
Your answer
Email address *
Double check! We'll be sending important info here...
Your answer
Cell number *
Your answer
Date of birth *
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DD
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YYYY
Health card number *
Health insurance company name and policy number if you have out-of-province/country insurance
Your answer
Allergies, Dietary, and/or Physical Conditions/Restrictions
Your answer
Gender *
What is your home church? *
TRANSPORTATION
While everyone is responsible to secure their own ride, we will try to help as much as we can!
Do you need a ride to UNPLUG? (Capernwray Québec) *
Can you drive people? *
If so, how many?
EMERGENCY CONTACT
Emergency contact full name & relationship to you *
Your answer
Emergency contact phone number *
Your answer
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