GHCリトリート2019 申し込みフォーム/GHC Retreat 2019 Registration Form
テーマ:福音によって繋がる / Theme : Gospel connects

日程:2019年9月21日(土)~23日(月・祝)/Date : Sept. 21(Sat.) - 23(Mon.), 2019
場所/Place:日本バイブルホーム(群馬県利根郡みなかみ町)/Japan Bible Home(Minakami, Gunma)
参加費/Registration Fee
・中学生以上/Adult (Jr. High and older):¥15,000
・小学生/Elementary school:¥11,000
・4歳以上小学生未満/Preschool age (4 years old and older):¥9,000
・4歳未満/under 4 years old:¥2,000

1泊2日参加 / Only 1 night and 2 days
・中学生以上/Adult (Jr. High and older):¥8,000
・小学生/Elementary school:¥6,000
・4歳以上小学生未満/Preschool age (4 years old and older):¥5,000
・4歳未満/under 4 years old:¥1,000

送信後5日以内に info@graceharborproject.jpより受付確認・今後の手続き等の連絡をいたします。
All those interested in attending please register using the form below. Please register as a family unit. Within 5 days of your registration, you should receive a reply from confirming your registration.

For further details on the Retreat, please check the Grace Harbor Church website.

お問い合わせは もしくはsatoshi@graceharborchurch.jpまで。
If you have any questions please e-mail or

参加者情報(1人目)First Registrant
For insurance purposes, we need to have every attender registered, including infants. Also, information regarding room preference, and additional details are required for each person. Please be careful to read to the end and confirm registration form before submitting.
1人目:氏名/Name 保険の関係で、本名でお願いします。Need real name for insurance purpose *
1人目:Eメールアドレス/Email address ご家族の場合、代表者のアドレス/If you join as a family, input main address. * から受信可能なもの、PDFファイルなどが受信可能なもの/ Please use an email address that you can receive confirmation e-mail from, PDF attachments, etc.
1人目:上記アドレスに加えてお知らせを受信したいEメールアドレス/Email address which you would like to receive the info additionally to above. から受信可能なもの、PDFファイルなどが受信可能なもの/ Please use an email address that you can receive confirmation e-mail from, PDF attachments, etc.
1人目:性別/Sex *
1人目:生年月日/Date of birth *
保険に加入するために必要な情報です。This is necessary for obtaining insurance for our group.
1人目:住所/Address *
1人目:電話番号/Phone Number *
1人目:区分/Age Category *
1人目:参加日程/Extent of Participation *
1人目:交通手段(レンタカーか自家用車)/Transportation (Rental Car or Private Vehicle) *
今年は水上駅への送迎はありません。We have no shuttle to/from Minakami station this year.
カーシェアを希望する方のみ/Those who want to share a rental car
レンタルするのは10人乗りのハイエースグランドキャビンです。/We are renting 10 seater vans.
Clear selection
食べ物のアレルギー等ございましたら(ご家族分全て)、こちらにご記入ください。/ Anything we should be informed in advance i.e. allergy about all your group members.
お一人で参加しますか?/Are you joining by yourself ? *
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