Bethany Retreat Center

RETREAT REGISTRATION FORM

To make a registration request on-line, please complete the form below,
then click on the Submit Button. Someone from the Retreat Center will contact you to confirm your request.
If you prefer to use regular mail, please CLICK HERE

Name:
Address:
City/State/Zip:
Phone (home):	(work):
Retreat:
E-mail:
Special Needs:
Deposit* Amount:
Would you like to be placed on our mailing list? Yes No
Would you like to be placed on our e-mailing list? Yes No

All reservations are subject to confirmation. If registering for more than one person, include name, address, and phone number of each person (see below). Accommodations during scheduled retreats are semi-private or private rooms. *Deposits are Non-Refundable
Person #2
Name:
Address:
City/State/Zip:
Phone (home):	(work):
Person #3
Name:
Address:
City/State/Zip:
Phone (home):	(work):