Retreat Registration

Student Retreat, Oct 14-16, 2022

Register and Pay

Step 1: Register

Please fill out the registration information below:

Name *

First

Last

Email *

LOCAL Address - (For Emergency Purposes Only) *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Birth Date: mm/dd/yy *

Year in School? *

Emergency Contact *

First

Last

Emegency Contact Phone Number *

Can you drive? *

Yes No

If you can drive, how many can you take, besides yourself? *

Dietary Information:

* Indicates required field

Are you a vegetarian? *

Are you allergic to gluten? *

* While we will do our best to accommodate you, if you have severe food allergies or intolerance, we suggest that you bring your own food for you to supplement your meals. There will always be simple options (salad, fruit, sandwich) if you are not able to eat the main entrees.

Submit and Pay Online

Student Retreat, Oct 14-16, 2022Register and Pay ​

Step 1: RegisterPlease fill out the registration information below:​

Dietary Information:

1850 Emerald streeteugene, oregon 97403​541-343-7021﻿(map)﻿

Student Retreat, Oct 14-16, 2022

Register and Pay

Step 1: Register

Please fill out the registration information below:

1850 Emerald street
eugene, oregon 97403
541-343-7021
(map)