Men's Retreat Registration Form

---

Men’s Retreat Registration Form October 14th – 16th, 2016 All Packages Include:  2 Nights Lodging  5 Meals (Dinner Friday & Saturday night | Breakfast Saturday & Sunday | Lunch on Saturday) Cost: $170 Please fill out this form and sent or drop a check payable to: PLCPC/ memo: MEN’S RETREAT Mail to/Drop Off: Point Loma Community Presbyterian Church Attn: Don Brenneman 2128 Chatsworth Blvd. San Diego, CA 92107 YOUR NAME:_________________________________________________________________________ HOME PHONE/CELL___________________________E-MAIL___________________________________ ADDRESS _____________________________ _____________________________ _____________________________ _____________________________ _____________________________

Enclosed is my payment in full for $170

I need financial assistance

Enclosed is my gift amount $_________ to assist with the Men’s Retreat Scholorship Fund. TRANSPORTATION: Please let us know if you need a carpool/van ride or would like to offer to drive. Do you need a lift?

Yes

I am willing to drive ______ people.

No