Retreatant Application

bearkat awakening 21 - september 13-15, 2019

RETREATANT APPLICATION:

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Gender *

Date of Birth *

Permanent Address *

City, State/zip code *

What size t-shirt (if any) would you like to order? *

Retreaters can opt out of receiving a shirt for the retreat, if they choose not to get one the fee will go down to $40.

College/University *

Classification *

Parent(s)/Guardian(s) Name *

Parent(s) address (If different from above) *

City, State/zip code *

Parent(s) phone number *

Food Allergies *

Where did you hear about Awakening? *

Do you require financial assistance *

Yes No

If so how much? *

Reason *

Comment *

The fee for the retreat is $50 this includes a shirt on Sunday of the retreat. If you choose to not have a shirt the fee does go down to $40.

Submit