Freedom at 55+ Retreat Registration

September 2-6, 2019

View the brochure for further information.

Registration Deadline is August 30, 2019.

General Information

* Indicates a mandatory field

*First Name

*Last Name

*Mailing Address

*Town/City

*Province

*Postal Code

*Phone

*E-Mail

Home Church

Retreat Information

*Desired Accommodation

Roommate(s)

Referral(s)

Specify each new attendee referred by you in order to receive a discount.

A confirmation package will be sent out after July 1st. I would prefer to receive my package by

Payment Method

You may choose to pay either the full fee or a non refundable deposit of $50 per person. The full balance is due upon arrival. *I wish to pay

Method of Payment*

Card Number*

Expiry Date* /

Name on Card*

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