Registration Form: Young Adults Spring Retreat 2015
We will gather at the Gratz Center Friday, April 24 at 6PM, and leave for Michigan at 6:30 sharp. Drivers should come to the loading zone on Delaware Place
(outside of the north entrance to the Gratz Center).

We will return to Gratz by 3PM Sunday, April 26.

View www.bit.ly/fpcya-0415retreat for more retreat details.
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Email *
What is the best email address to reach you?
Phone Number *
What is the best phone number to reach you?
Alternate Phone *
Give us a backup phone number, just in case.
Emergency contact name *
Who is the person you would like us to contact in the off chance there is an emergency?
Emergency contact phone *
What is the phone number of your emergency contact?
Can you drive? *
Do you have a car that you're willing to drive to Michigan? (save your receipts, we reimburse fuel and tolls)
If yes, how many people can you fit in your car, including yourself?
Total number (comfortably, including yourself) w/ space for luggage/supplies.
Name *
What is your full name?
Required
Do you have any dietary restrictions or foods you avoid?
e.g., vegetarian, vegan, allergies, etc.
Do you have special concerns or circumstances of which we should be aware?
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