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2019 Fall Family Retreat Day Registration

We are super excited that you have chosen to join us for the R[4] 2019 Fall Family Day Retreat!

Be advised, this registration is NOT for overnight campers. This is your registration for Saturday, September 14 ONLY. Please complete and submit the form below. More information will be sent upon receipt of your registration.

FYI

Campers arrive at Camp Copass for registration at 9:00am on Saturday, September 14, 2019.

All meals (Lunch, Dinner, Snacks) and activities are provided.

Day Retreat Campers Depart at 9:00pm

Camper Contact Information

Name

First Name

Last Name

Verify Email

Cell Phone Number

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Retreat Ticket Information

Payment Options

You may choose to pay in full today or pay a $15 deposit.

Pay In Full

Bill Me Later

Payment Amount *	Quantity
$15 - Fee Per Person - Pay in Full
$15 - Retreat Deposit

Payment Date

If you are paying the deposit only today, when would you like to be billed for the balance?

Family Information

Please provide the following information to complete your registration.

Full Names and tshirt sizes of all Parents/Guardians/Caregivers Attending:

Full Name of Child #1

Age of Child #1

Diagnosis (if Applicable)

Tshirt Size for Child #1

Full Name of Child #2

Age of Child #2

Diagnosis (if Applicable)

Tshirt Size for Child #2

Full Name of Child #3

Age of Child #3

Diagnosis (if Applicable)

Tshirt Size for Child #3

Full Name of Child #4

Age of Child #4

Diagnosis (if Applicable)

Tshirt Size for Child #4

Full Name of Child #5

Age of Child #5

Age of Child #6

Diagnosis (if Applicable)

Tshirt Size for Child #5

Tshirt Size for Child #6

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