At the Circle of Nations Retreat Lodge
on More Mountain,
Eureka
Springs, Arkansas
March 13, 14 &15, 2009
Printable
OFFLINE REGISTRATION FORM
Name_____________________________________________________Address___________________________________________________
Phone___________________________
E-mail___________________________
Diet:
Vegetarian____ Regular____ Special_________
Deposit: $75.00 (non-refundable, required to hold space)
Check____ (Payable to CIRCLE STUDIOS)
Money Order____ (Payable to CIRCLE STUDIOS)
Visa or Mastercard #:_____________________________________Name:____________________________________Exp:____________
Will arrive:___________________
Need airport pickup_______ (Additional $55.00 one way)
Need directions_______ Send them e-mail____ or snail mail____
Snail mail directions to:_______________________________________Send the original, fully completed Registration Form to:
The Married Couple's Retreat
c/o Phil Childers
6907 Village Green Blvd.
Pewee Valley, KY 40056