For individual registrations, complete the form below.To request and invoice or register a group, please contact us. Include: the organization, number of people and contact information. Thanks. We will send you an invoice.Registration IDPersonal InfoName First Last Email Enter Email Confirm Email PhoneAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer or Place of Work Occupation or Position Title Retreat DetailsRetreat Date*Select the specific retreat for which you are registering.Indicates a retreat for Workplace Wellness and Staff Vibrancy. Indicates a retreat for Christians - staff, teams, small groups, and individuals. Sep 16 (8:30 am - 10:30 am): A Rest That Works at The Community Grief Center (Fort Wayne, IN) Sep 16 (11:30 am - 1:30 pm): A Rest That Works at The Community Grief Center (Fort Wayne, IN) Sep 16 (2:30 pm - 4:30 pm): A Rest That Works for Ministry Leaders at The Community Grief Center (Fort Wayne, IN) I will be attending as a… standard participant ($49) spouse ($29) student ($19) alumni ($19) LunchYou can bring your own lunch OR purchase one that includes pizza, salad, and dessert. I will be bringing my lunch. I would like to a purchase a lunch. ($6) HiddenSandwich/Wrap Options Turkey Club Wrap: Turkey, Lettuce, Tomato, Bacon & Dijonnaise Sauce. Wise Guy Sandwich: Ham, Salami, Banana Peppers, Olive Tapenade, Shredded Mozzarella Cheese, Lettuce & Italian Dressing on French Bread. Veggie Lovers Wrap: Hummus, Red Onion, Tomato, Cucumber, Lettuce & Shredded Carrot. HiddenAdditional Lunch Options Gluten Free Dairy Free Vegan Additional NotesAdditional notes on this registration (additional registrants, special needs, etc.)PaymentDiscount CodeIf you were provided a registration discount code, enter it here. Total HiddenTotal (for use in conditionals)Credit CardCard Details Cardholder Name PhoneThis field is for validation purposes and should be left unchanged.
