Women's Retreat Registration Form
First United Church of Christ, 34 West Main Street, Milford, 06460
Phone: 203-877-4277
March, 2018
Women: Members & Friends Welcome

Retreat Location - Orange Congregational Church
205 Meetinghouse Ln, Orange, CT 06477

Friday, March 2
7pm - Post-work meditation and framing the retreat
9pm - End time

Saturday, March 3rd
8am - Doors open and breakfast begins
9:30am - Start time - Introduce the day, have some breakfast
10:00am - First session
11:30am - Break
Noon - Lunch (crockpot-style potluck)
1:00pm - Second session
2:30pm - Snack
3:00pm - Closing service
4pm - End time

Invite your Friends!

Registration: $25 (Make payable to First United Church of Christ, memo--Women's Retreat, or pay online.)

Lunch: Please indicate any dietary restrictions and if you are able to bring a potluck soup or stew

Chair Massage: To be scheduled at the morning check in. If you know you are interested, please indicate in the comments. Sessions are $20 for 15 minutes and you would need to bring cash with you.

Overnight: The Orange Congregational Church does not offer overnight accommodations. Michele Olsson and her mother have graciously offered the use of their condo for anyone who would like to stay overnight in community. If you are interested in this, please indicate in this form. Please note we have limited space!

Email address *
Name *
Your answer
Address/City/Zip *
Your answer
Phone Number(s) home/cell/work *
Your answer
Email Address(es) *
Your answer
Emergency Contact & # *
Your answer
Please include any special needs, allergies, or dietary restrictions (per participant) *
Your answer
Are you able to bring a soup or stew to share? If so, please include what you would like to bring.
Your answer
Are you interested in a chair massage?
Your answer
Are you interested in overnight accommodations?
Your answer
PARTICIPATE & TREAT: It is the highest priority of First United Church of Christ, Congregational, of Milford staff and volunteers to keep all participants and volunteers safe during our time together. LIABILITY: I understand and agree that neither the volunteers, nor the church, nor the church’s staff/clergy can be held responsible for injuries or other problems that I may incur while participating. Furthermore, I hereby assume all risk and personal injury, sickness, death, damage, and expense as a result of participation in these activities. MEDICAL: I attest that I am in good physical condition to participate in Yoga and other activities. Should any accident or illness occur during the retreat, I will not hold First UCC of Milford or its staff or clergy or volunteers responsible for medical aid rendered. In the event it becomes necessary, I give permission to organizers to seek first aid or emergency medical treatment. CONSENT FOR PHOTOGRAPHS & VIDEOS: I hereby authorize and give full consent, without limitation or reservations, to First UCC of Milford to publish any photographs or videos in which I appear appear while participating in any part of this Women's Retreat 2018. There will be no compensation for use or any photographs or videos at the time of publication or in the future.
Volunteer Opportunities *
As part of the Women's Retreat, we seek the support of parents. Please mark the choices you prefer or indicate how you are able to help.
PAYMENT (Due by February 27)
Submission of this form is your permission of participation.
Your answer
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