Womens Retreat Form

First name

Last name

Address

Phone

Email

Are there any dietary restrictions? If yes, please describe:

Interested in helping to lead music, devotions, and/or activities during the retreat? If so, list what you'd like to do (teaching a craft, guiding us through yoga, leading us on a wal, etc.)

Lodging at Woodland Ridge is three women to a room. If you know one or two other attendees that you'd prefer to room with please list their name(s) :

Need a scholarship in order to attend:

Yes, in the amount of $ ___________

No

Emergency contact (name and phone number):

Women's Retreat Form

Menomonie United Methodist Church