2018 Summer Retreat Registration

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Date
Date
Name *
Name
If yes, please type in his/her name.
If yes, please list name(s) and age(s).
Your Phone
Your Phone
How many dogs are you bringing? (only dogs are allowed)
How will you be paying for the retreat?
Make checks payable to "Siloam Community Church"
Would you be willing to drive and give a ride for people? If yes, how many?
If you can't give a ride to someone or if you prefer to carpool but not drive, skip this question.