Women's Retreat Registration Form
Event Timing: Feb 9-11th, 2018
Event Address: Circle Square Ranch, Brantford, ON
1645 Colborne Street East, Brant, ON, N3T 5L4
Ph- 519.754.0171
https://www.csranchgrandriver.ca/

Cost: $135 if registration is submitted by Jan 1 and $145 if it is submitted after Jan 1st, 2017
Please make cheques payable to New Street CRC and indicate "women's retreat" on memo (Cheques submitted to Wendi Leest or Trudy Sykes.)

Please note, most retreat related communication will be done via email.

Email address *
First name *
Your answer
Last name *
Your answer
Home address *
Your answer
City *
Your answer
Province *
Your answer
Postal code *
Your answer
Cell number (by listing it-I authorize you to text me about the retreat)
Your answer
Dietary restrictions *
Do you have any special needs, accommodation requests or have medical conditions that require special assistance? If yes please indicate any accommodations that you require. We may be in touch with you to ensure we can meet your needs for this event.
Your answer
Emergency contact name & phone number *
Your answer
Home church or church affiliation *
Horseback riding may be available for a small fee, please indicate if you are interested.
Consent form
All participants under 18 must register with this form and in addition obtain authorization from a parent/guardian in order to participate.
Follow the link and it will open the form in a separate window for you to print and fill out (link)
Once completed, please submit along with payment and you are good to go!
Click on the 'SUBMIT' button below to date and complete the registration form. Upon registration, fees due are: $135 if completed on or before Jan 1/2018, $145 if it is submitted after Jan 1. Please make cheques payable to New Street CRC and indicate " women's retreat" on memo. Please only complete one form and if you have any questions or payment please contact Wendie Leest at wendileest@cogeco.ca or Trudy Sykes at sykes@ouac.on.ca
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