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Cell Phone Number
Please list any dietary restrictions you may have
Emergency Contact Information
Parent / Guardian Name
Parent / Guardian Email
Parent / Guardian Cell Phone Number
Do you have a car and would be willing to drive?
Approximately a 5 minute drive from campus
Please choose one of the following regarding payment:
Please email Sr. Leandra (firstname.lastname@example.org) if you have any questions or require a scholarship
I will pay the $20 retreat fee to Sister Leandra by the day of Kairos.
I will need a scholarship.