Man Up: Weekend Edition

October 5-7, 2018 | Man Up: Weekend Edition
Alpine Villa Tuscan Retreat Center
Breckenridge, CO

Check-In: Starting at 4:00pm

Deposit Price: $75
Registration Price: $175.00 (total due by September 30, 2018)

Contact:
Grant Leitheiser
grant@goodsoilcounseling.com

Contact Information

Name

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Email

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Phone

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Address

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What is your age?

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Please select one option.

18-25 26-35 36-45 46-55 55+

Preferences

Allergies?

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Gluten Free Dairy Free Nut Free None Other:

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Service and Life Group Info

Do you regularly attend BVCC?

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Yes No

If so, for how long?

If you have been involved in a Life Group, which one?

Carpool

Are you interested in carpooling to the retreat?

Please select one option.

Yes - I need a ride Yes - I am can drive (can transport 1-2 other people) Yes - I can drive (can transport 3-4 people)

Payment

Total Amount ($175.00) Deposit ($75) Pay By Check (0)

Amount

Total amount is due by September 30, 2018.
We cannot grant refunds for any charges, sorry for the inconvenience!

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

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Description

October 5-7, 2018

Man Up: Weekend Edition
Alpine Villa Tuscan Retreat Center
Breckenridge, CO

Check-In: Starting at 4:00pm

Deposit Price: $75
Registration Price: $175.00 (total due by September 30, 2018)

Contact:
Grant Leitheiser
grant@goodsoilcounseling.com

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