Eucharist Fall Retreat 2018 Registration Form
Mt. Hermon | Friday evening - Sunday noon (November 9 - 11)
Email address *
Full Name(s) of all individuals in your party. Indicate if any are children (and their age). *
Your answer
Phone number *
Your answer
Will you need a ride? *
If you are driving, please tell us how many seats you have available (if any) and where, geographically, you will be coming from on Friday.
Your answer
Special dietary restrictions? (follow-up form will be emailed to you directly)
Anything else we should know (or questions you have)?
Your answer
Please calculate your own registration cost and indicate how you are paying.

Suite (private room with queen sized bed / sleeps up to 5):
Adult Early Bird Rate (through Oct 1) - $210 / per adult person
Standard Adult Rate (through Oct 24) - $245 / per adult person

Shared room
Early Bird Rate - $170
Standard Rate - $195

Children Ages 0 - 4 are free!
Early Bird Rate - $90
Standard Rate - $100

Full Time College Student Rate - $100
Day rate (Saturday only / includes meals) - $50

If money is a barrier to your participation, we will find a way to make this work for you.

How much will you be paying? (Write TBD if requesting scholarship) *
Your answer
How are you paying? Registration is not complete until we receive your payment. *
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