Retreat Request Form
Group Name:
*
Contact Name:
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Nationalities in Attendance
*
Check Age Group in Attendance
*
Children
Youth
Young Adults
Adults
Male
Female
Number of Guests
*
Date Preference 1
-
Month
-
Day
Year
Date Picker Icon
Date Preference 2
-
Month
-
Day
Year
Date Picker Icon
Arrival Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Departure Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Been to OVPC before
*
Yes
No
How did you hear about OVPC?
*
Friend
Online Search
Church
Additional Comments
Submit
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