COUPLES:
Contact Name:
Name of Spouse:
Address:
City, State, Zip:
Telephone:
Email:
Program Desired:
-Please choose ONE-
Couples Intensive
Courageous Hearts
Follow Your Heart
Going Deep
Getting Physical
Passion of Christ in the Heart of a Marriage
Prepare to Last
Romantic Adventure
Check-in Desired:
-Month-
January
February
March
April
May
June
July
August
September
October
November
December
-Day-
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-Year-
2009
2010
2011
Check-out Desired:
-Month-
January
February
March
April
May
June
July
August
September
October
November
December
-Day-
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-Year-
2009
2010
2011
Comments / Questions:
GROUPS:
Contact Name:
Address:
City, State, Zip:
Telephone:
Email:
Group Affiliation:
#
of Attendees:
Type of Group:
-Please choose ONE-
Church - Men's
Church - Women's
Church - Couples
Church - Leadership
Corporate
Elder/Deacon Retreats
Prayer Retreats
Senior Adult Tour Retreats
Ministry Donor Retreats
Strategic Planning Retreats
Retreats for other Marriage ministries
Check-in Desired :
-Month-
January
February
March
April
May
June
July
August
September
October
November
December
-Day-
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-Year-
2009
2010
2011
Check-out Desired :
-Month-
January
February
March
April
May
June
July
August
September
October
November
December
-Day-
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-Year-
2009
2010
2011
Comments / Questions: