Registration Intake Form

Welcome Letter
We offer weekend retreats to assist men and women to combat lies they are believing about themselves or about God and help them navigate their way back to the truth. During the retreat weekend, we will take a journey through God's word, and we will focus on the truth of who God is—including His splendor, His majesty, and many of His attributes. We will also be looking at our true identity in Christ Jesus in order to overcome the lies.

Come spend a weekend away from the chaos of everyday life and get away to a peaceful and beautiful location in the hills of north San Diego County to meet with your creator, God. Our ministry team will walk alongside you throughout the weekend and guide you through the truth of God's word and help you to cast off the lies you believe about yourself and help you take hold of and embrace God's truths and His promises for you.

The weekend will consist of several group sessions where we will be teaching God's truth. In addition, it will include a variety of breakout sessions.

The retreats are open to both men and women. Men and women will be together during the teaching sessions, but they will be separated during the breakout sessions.

When we receive your completed and signed Registration Intake Form and payment, you will be considered registered.

Prior to attending the retreat, we will send you a confirmation packet with details about the retreat weekend. Please don’t hesitate to contact me with any questions or concerns.
Registration Intake Form
Today's Date*

MonthDayYear
Date
Dates of desired retreat*

MonthDayYear
Date
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip
Email Address*

Confirmation Emailexample@example.com
Phone*
Age
Sex*

MaleFemale
What is your marital status?*

MarriedSingleSeparatedDivorcedWidowed
Do you consider yourself to be a Christian?*

YesNo
If yes, how long?*
Are you currently affiliated with a church?*

YesNo
If yes, where do you attend church?*
What is the denomination?*
How would you describe your Bible knowledge?*

ExtensiveModerateLimitedNo knowledge
What would you like to gain from attending this retreat?*
Please list lies you are believing about yourself.*
Please list lies you are believing about God.*
Check the strongholds that you struggle with.*

ShameCriticalImpatientFearJudgmentalWorkaholismAngerControllingPrideBitternessEnvySelf-relianceResentmentJealousyLogic/ReasonSelf-sabotagingLazinessLustComfortGluttonyPornographyProcrastinationFoodAlcohol / DrugsNone of the above
Please list additional strongholds you struggle with that are not mentioned above.*
Have you experienced trauma in your life?*

Sexual abuse or molestationRapeVerbal or mental abuseAbortionPhysical abuseNoOther
Please briefly explain the traumatic event(s).*
Have you been diagnosed with post-traumatic stress disorder (PTSD).*
Are you currently taking medication for emotional issues or mental illness?
Are you currently under the care of a counselor, therapist, or psychiatrist?*

YesNo
Do you have any food allergies? If so, please list them.*
How did you hear about us?*

A friendFacebookOur websiteInstagramWeb searchNoOther
Emergency Contact Name*
Emergency Contact Phone Number*
WE ARE NOT LICENSED PROFESSIONAL COUNSELORS

Choosing Truth Team Members are peer volunteers and are not licensed professional counselors. Choosing Truth retreats are not intended to take the place of professional counseling or treatment.

By signing below, you are acknowledging the fact that we are not licensed professional counselors and that we are lay Christians with a desire to lead participants back to the truth of God’s Word.
CANCELLATION POLICY

If you find that you are unable to attend the retreat, full refunds are available up to two weeks prior to the retreat.

Refunds are not available if you cancel within two weeks of the retreat.
I have read and agree to the cancellation terms above*

YES
Printed Name*
Signature*

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Registration Fee
$250.00

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Welcome Letter

Registration Intake Form