Winterblast

Participant Contact Information

Please complete form for each student & leader in your group.

(Groups must bring at least one male leader for every 10 guys and one female leader for every 10 girls who register.)

Name

Phone Number

Address

Registration Information

Registration Type

Student
Leader

Date of Birth

Gender

Male
Female

Week Attending

Group Name

Add Winterblast T-shirt ($10)

Running Total

$0.00

Total

$0.00

Terms & Agreements

Cancellation Policy

It is agreed that this contract may be canceled at any time prior to 90 days before the beginning of this retreat with a 25% forfeiture of our deposit. Cancellations made within 45 days of the retreat start date will result in a 50% forfeiture of our deposit. If cancellation occurs within 30 days before the beginning of this retreat, the entire deposit will be forfeited.

I have read and agree to the terms above.

Billing Information

Name

Credit Card

Visa
Mastercard
American Express
Discover

Address

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