Light of Christ - 2024 Ladies Retreat

If you have any questions, please contact Jessica Hartrich at jessislu@hotmail.com

Personal Information

Name

*

Email

*

This address will receive a confirmation email

Cell Phone

*

Address

*

Registration Type

*

Please select all that apply.

Early Bird - By 8/15/2024 - $85 After 8/15/2024 - $99 Day Only - $85

Roommate Requests

Bed Preference (e.g. bottom bunk only)

*

Home Church, if any

*

Guest of

Carpool

Carpool Options

*

Please select all that apply.

I need a ride I can take passengers I'm driving alone I'm riding with someone else (specify)

Number of Passengers I can take

If driving, who are you taking with you?

If riding with someone else, who is it?

When can you leave the East Valley?

*

Geographic Area

*

Please select all that apply.

South Gilbert North Gilbert Queen Creek South Chandler North Chandler San Tan Valley East Mesa / AJ Other - Specify below

Specify Other Geographic Area

Other Information

Comments/Dietary or Other Needs, Allergies, etc.

Payment Options

Payment Type

Early Bird - By 8/15/2024 ($85) After 8/15/2024 ($99) Scholarship Needed (Specify) ($0) Check/Cash (Specify below) ($0)

Amount

Payment Comments

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

If you have any questions, please contact Jessica Hartrich at jessislu@hotmail.com

Please Fix the Following

Close