SA Registration Form (Square)

SA Registration Form for the SA/S-Anon NW Regional Retreat at Aldersgate

September 18-20, 2026
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Gender*

MaleFemale
Are you...

Willing to be of service at the retreat?Wanting to participate in the variety show?Available to sponsor?Looking for a sponsor?
Dietary Restrictions

Gluten FreeDairy FreeNut AllergyVegetarianVegan
All registrations include 5 meals except Saturday only, which includes 3 meals. All private cabins and lodging include linens. Please select one lodging choice only. Each option is per person. Each individual registers seperately.
Willing to carpool?

Yes
Requested Roommate
Payments are processed through Square. We do not store the Payment card or address information.

Registration Types

Private Lodging w/ Meals

Private with in-suite, private bathroom. 2-3 people per room. Linens/towels included.

$260.00

Cabin lodging w/ Meals

Semi-private with detached, shared bathrooms; one women’s and one men’s. Linens/towels included

$225.00

RV or Tent w/Meals

$140.00

No Lodging w/Meals

$140.00

Saturday Only w/Meals

$75.00

Total

$0.00

Credit Card

Apple Pay

Google Pay

SA Registration Form for the SA/S-Anon NW Regional Retreat at Aldersgate