FEBRUARY 21-22, 2025

To confirm your reservation, please continue through the entire form. Confirmation and event instructions will be provided at the end of the form.

GENERAL INFORMATION

First Name *

Last Name *

Mailing Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Church Name *

Church City *

RESERVATION INFORMATION

Enter "1" next to the Option you choose.

	Option #1: Friday Only - Includes 1 day of event activities and 1 meal. No lodging. Price Per Person: $95
	Option #2: Saturday Only - Includes 1 day of event activities and 2 meals. No lodging. Price Per Person: $95
	Option #3: Two Days No Lodging - Includes two days of event activities and 3 meals. Price Per Person: $130
	Option #4: Bunkhouse - Includes 2 days of event activities, 3 meals, and Bunkhouse Lodging. Bring your own linens. Price Per Person: $165
	Option #5: Triple Occupancy Motel Room - Includes 2 days of event activities, 3 meals, and Motel Lodging. Price Per Person: $170
	Option #6: Double Occupancy Motel Room - Includes 2 days of event activities, 3 meals, and Motel Lodging. Price Per Person: $175
	Option #7: Single Occupancy Motel Room - Includes 2 days of event activities, 3 meals, and Motel Lodging. Price Per Person: $195

T-SHIRT

A T-Shirt is included in the event fee.
Enter "1" next to the Option you choose.

	T-Shirt - Adult Small
	T-Shirt - Adult Medium
	T-Shirt - Adult Large
	T-Shirt - Adult XL
	T-Shirt - Adult 2XL
	T-Shirt - Adult 3XL
	T-Shirt- Adult 4XL

SPECIFICATIONS

Do you have any Food Allergies or Specified Diet?
Special food will be available ONLY for those who specify a food allergy or dietary request e.g. vegetarian, gluten free, dairy free, etc.
List your food allergy or request here:

Roomates:
If you chose double or triple occupancy, who are you rooming with?
List the roomates name here:

PAYMENT METHOD

Indicate how you will pay for the event below. *

Pay By Check

Pay By Credit Card - Full balance will be charged to the credit card at the end of this process. Credit Card process fee of 3.7% is included.

Final Instructions

- Once you click "Next" the system will show a summary of your reservation. Click the "Back" button at the bottom of the page if you need to make a change.

- The option to pay by check or credit card will appear below the summary.

Choose one of the payment options again. If you are paying by credit card, the system will ask for the credit card information and will charge the FULL amount at this time.

-Click "Continue" one more time to complete your reservation form.

- At the end of the process, you will receive an email. This email will have a link for a Medical Release Form. A signed Medical Release Form is required at check-in on for each person attending the retreat.

- Registration is transferable but non-refundable. If you have purchased a registration and cannot attend, please consider this an opportunity to give your registration to someone who may not otherwise have been able to attend.

- If you have any questions, please contact Highland Lakes Camp office: 512-264-1777.