Retreat Registration Form

Our 2025 event has SOLD OUT! Please click here to be added to the Wait List.

Name:

Phone:

Street Address

City

State

Zip

Email:

Room Type (if available)

Shared Room ($245)

Private Room ($265) SOLD OUT

Shared Room with Bath ($285) SOLD OUT

Private Room with Bath ($295) SOLD OUT

Roommate(s) (if applicable)

Extended Stay

Sunday, October 12 (additional $80)

Emergency Contact Name

Emergency Contact Phone

Request Scholarship

I would like to attend this retreat, but need financial assistance

Please list any food allergies or dietary restrictions

Is this your first time attending this retreat?

YES

If so, how did you hear about this retreat?

Are you interested in purchasing a Women's Spiritual Retreat sweatshirt?

A NOTE ON SCHOLARSHIPS

We are thrilled to have a scholarship fund to help women who otherwise could not afford to attend.

Accountability is a necessary part of recovery, therefore, we do not offer full scholarships to any one person.

Our scholarship will cover half of your cost.

We will be happy to set up a payment plan for your half, to further assist you if necessary.

Each of us doing our own footwork is also a vital part of recovery, and would encourage recipients to participate, volunteer to help with set-up, clean-up or other various tasks at the retreat &/or our events throughout the year.