2026 Family Retreat Registration Form
March 6 - March 8 | Circle Lake Retreat Center
Are you attending:
*
Full Weekend
Saturday Only
Are you looking to register an Individual or a Family?
Individual (must be above 18 years old)
Family
REGISTRANT INFORMATION
Registrant Name
*
First Name
Last Name
Email
*
example@example.com
Cell Number
*
PARENT/GUARDIAN INFORMATION
Mother/Guardian Name
*
First Name
Last Name
Email
*
example@example.com
Cell Number
*
Will you be attending the retreat?
*
Yes
No
Father/Guardian Name
*
First Name
Last Name
Email
*
example@example.com
Cell Number
*
Will you be attending the retreat?
*
Yes
No
Would you like to register any children?
*
Yes
No
CHILDREN INFORMATION
How many children are you looking to register?
*
Please Select
1 child
2 children
3 children
4 children
Child 1 Name:
*
First Name
Last Name
Age (Child 1)
*
Grade (Child 1)
*
Please Select
N/A
PreK
Kindergarten
G1
G2
G3
G4
G5
G6
G7
G8
G9
G10
G11
G12
Allergies (Child 1)
*
Child 2 Name:
*
First Name
Last Name
Age (Child 2)
*
Grade (Child 2)
*
Please Select
N/A
PreK
Kindergarten
G1
G2
G3
G4
G5
G6
G7
G8
G9
G10
G11
G12
Allergies (Child 2)
*
Child 3 Name:
*
First Name
Last Name
Age (Child 3)
*
Grade (Child 3)
*
Please Select
N/A
PreK
Kindergarten
G1
G2
G3
G4
G5
G6
G7
G8
G9
G10
G11
G12
Allergies (Child 3)
*
Child 4 Name:
*
First Name
Last Name
Age (Child 4)
*
Grade (Child 4)
*
Please Select
N/A
PreK
Kindergarten
G1
G2
G3
G4
G5
G6
G7
G8
G9
G10
G11
G12
Allergies (Child 4)
*
YOUR WEEKEND PLANS
Are you attending:
*
Full Weekend
Saturday Only
PAYMENT METHOD
Select a Payment Method
*
Pay Online
Pay by Check or Cash
PAY ONLINE
Please check one of the following and proceed with your payment
Categories:
All
All
FULL WEEKEND
SATURDAY ONLY
Gift a Retreat Experience
prev
next
( X )
FULL WEEKEND
Full Weekend Registrant-Adult or Youth
Adult or Youth
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
Full Weekend Registrant- Child
3-12 Years Old
$
95.00
Quantity
1
2
3
4
5
6
7
8
9
10
Full Weekend Registrant-Toddler
Below 3 Years Old
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
SATURDAY ONLY
Saturday Registrant- Adult or Youth
Adults Only
$
105.00
Quantity
1
2
3
4
5
6
7
8
9
10
Saturday Registrant- Child
3-12 Years Old
$
85.00
Quantity
1
2
3
4
5
6
7
8
9
10
Gift a Retreat Experience
Sponsorship- Level 1
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Sponsorship- Level 2
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Submit
PAY BY CHECK OR CASH
Payer Name
*
First Name
Last Name
Cell Number
*
Email
*
example@example.com
Submit
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