Brothers 2024 Fall I’tikaf Retreat Registration

REGISTRANT INFO

Full Name *

Phone *

Email Address *

Age *

Occupation *

City *

State/Province *

Country

EMERGENCY CONTACT

Full Name *

Relationship to Registrant *

Phone *

CONSENT AGREEMENTS

Attendance Policy

Electronics Policy

Children Policy

PAYMENT

$50 for adults and $25 for students are the registration costs for the brother's retreat. This includes cost of meals and general accommodations.

Attendee Type *AdultStudent

Payment Type *ZelleCredit Card

Attendance Cost

Zelle Transaction IDAddress the zelle payment to admin@refinedheart.com and enter the transaction id here.

Credit / Debit Card *

By filling this field I authorize Refined Heart NFP to charge my credit card at the amount listed above for the agreed upon purchase(s).

For any questions or concerns, please contact us at admin@refinedheart.com.