Woodbine Baptist Church - Women's Retreat

Women's Retreat at Camp Baldwin

First Name

Last Name

I am member of:

Woodbine Baptist Church

Woodbine Young Adult Ministry

Other Church

If other: What Church?

Phone Number

Email

Do you want a single room or double room with someone? (Single price: $220, Double Price $180)

Single

Double

Is there a friend you would like to room with?

Do you have any allergies or food restrictions? (i.e. gluten, nuts, etc.)

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone Number

Are you in need of a scholarship?

No

Yes

Would you like to purchase a shirt for an additional $20?

Yes

No

Media Release

I hearby authorize Woodbine Baptist Church, or any other church apart of the event, to take pictures of me for use in social media.

Yes

No

Signature

Payment

Payment Type

Credit/Debit card

Check

**There is a $5 Fee for all card charges**

Once form is submitted, you will be redirected to the payment tab for this event. Please have your payment option ready. (Debit/Credit Card)

If paying with check - please make check out to "Woodbine Baptist Church" with a note that it is for the Women's Retreat.