Young Adults Retreat Registration Name* First Last Email* Phone*Transportation* Church Bus/Van Driving on own Driving with? I have room for more people.* Yes No How many more can you take?* Emergency ContactsAllergies/Dietary RestrictionsYA Retreat Registration* Price: I would like to donate funds towards a scholarship. Please indicate amount. Total $0.00 Credit CardCard Details Cardholder Name Terms and ConditionsMedia Liability Release: By registering, I am giving Grace Chapel permission to use images, videos, or quotes taken of me/my children in promotional materials, in the newsletter, on the website, or in any capacity for any use in perpetuity. 52347Δ