Radiance & Renewal 2017 Fall Retreat Registration Form
We're so excited that you can join us for annual retreat with Radiance and Renewal churches! Early Registration ends Aug. 6, 2017. Last day for regular registration is Aug. 27, 2017 and late registration ends Sept. 17.

WHEN: Sept. 22 (evening) - Sept. 24 (late afternoon)
WHERE: Mount Hermon Christian Conference Center
ADDRESS: 37 Conference Dr., Mt. Hermon, CA 95041
THEME: "Wholehearted"
SPEAKER: Pastor Eddie Kim, Worship Pastor at Southland

--Early registration is $130 (until 8/6)
--Regular registration is $160 (until 8/27)
--Late registration is $190 (until 9/10)
*All meals and lodging are included in price. Kids under age 12 are $25.

The preferred method of payment is cash or check. Give payments to Serena Tom or Caroline Kim. Or you can also use PayPal by sending your payment to "pay@radiancesf.org." Please write "ANNUAL RETREAT" in the NOTES on the checks and for PayPal. Your payment won't be counted without the notation. Checks should be addressed to "Radiance Christian Church."

*For those who are in need of financial aid, please contact Serena Tom "serenatom@radiancesf.org" or Caroline Kim (for Renewal attendees) no later than August 20. Thank you!

Form link: https://goo.gl/1NbSwG

First Name *
Your answer
Last Name *
Your answer
Which church are you a part of? *
What's your gender *
Phone Number *
Your answer
Email *
Your answer
Address *
Your answer
Name of other adults in your group
Your answer
Email of the other adults in your group
Your answer
Children in your group (name and ages)
Your answer
Emergency Contact (and relationship) *
Your answer
Emergency Contact's Number *
Your answer
Do you need any special retreat accommodations? (i.e. health concerns, dietary restrictions, etc.?)
Your answer
What's your T-shirt size? *
Do you need additional T-shirts for others in your group? If so, which size(s)
Your answer
Would you be interested in using the ropes or adventure course at Mt. Hermon during free time? More info at http://mounthermonadventures.com/
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