Bethany Retreat Center Email Address
 
home button
register button
events button
about button
directions button
links button
faq button
contact button
donate button
shop button
payment button
Email Newsletter icon, E-mail Newsletter icon, Email List icon, E-mail List icon
Join our FREE Email Mailing List

Retreat Registration Form

 

To make a registration request on-line, please COMPLETE the form below
(Please fill out ALL the fields that apply, including your address.),
then click on the Submit Button.
If you prefer to use regular mail, please
CLICK HERE

Name:
Address:
City/State/Zip:
Phone (home): (work):
Retreat:
E-mail:
Special Needs or Personal Retreat dates:
Do you have any dietary, allergy or special health needs? Please let us know of ANY special requirements you might have. Also, please use this box to tell us what dates you'd like if you've selected a Personal Retreat.
How did you hear about us?
   
Deposit* Amount:
Would you like to be placed on our mailing list?       Yes   No
Would you like to be placed on our e-mailing list?   Yes   No

All reservations are subject to confirmation. If registering for more than one person, include name, address, and phone number of each person (see below). Accommodations during scheduled retreats are semi-private or private rooms.
*Deposits are Non-Refundable

Person #2
Name:
Address:
City/State/Zip:
Phone (home): (work):
Special Needs:
Do you have any dietary, allergy or special health needs? Please let us know of ANY special requirements you might have. Thanks.
Person #3
Name:
Address:
City/State/Zip:
Phone (home): (work):
Special Needs:
Do you have any dietary, allergy or special health needs? Please let us know of ANY special requirements you might have. Thanks.
Required:

Enter web form code
Web Form Code

   

NOTE: After you have submitted the Reservation Form, you will be taken to a page where you have the option of paying your deposit with your credit card using PayPal. You can also send the deposit payment using a check if that is your preference.



©2005-2017 Bethany Retreat Center - All rights reserved.
Website designed by
Smoking Dragon Artworks
facebook buttonVisit Us on Facebook