Matt Talbot Group 142 - 17th Retreat Retreat Dates: April 24th – 26th 2015 Name: ___________________________________ Address: ___________________________________ City: State: Zip: __________________ ____ ________ Phone: Cell: ________________ ______________ Email: ____________________ Is this your first Matt Talbot 142 retreat? Y___ N ___ Are there any changes to your contact info? Circle one: Y / N Would you like to volunteer? Coffee Registration Set-up/Breakdown Hospitality Matt Talbot Group 142 provides a limited number of partial scholarships for those who may not otherwise benefit from attending the retreat. Scholarships are made available through the generosity of our fellow members. Please indicate the amount you would like to contribute to a scholarship: $20 __ $50 __ $100 __ $170 __ (other) $ ____ Summary of Fees: please check one: Private Room: $225 Double Room: $170…….Do you have a preferred roommate? Roommate name here: ____________________________________ Scholarship: $ _______ (optional) Total enclosed: $ ______ Please submit Registration by March 31,2015 Payments are non-refundable but may be transferred to someone else. Registration is first come first served. Payment will be returned if retreat reaches capacity. Remit payments to: Matt Talbot Group # 142 2879 HWY 160 West - P.O. Box 4862 Tega Cay, SC 29708 Call Ben J. For Details 803-517-8305 We look forward to seeing you there!
© Copyright 2020