*Name:
*Address:
Email address:
*Phone number:
*Days Attending:
Overnight
Friday only
Saturday only
Friday and Saturday
*Meals:
Check all that apply
Friday Lunch
Friday Dinner
Saturday Breakfast
Saturday Lunch
Questions or Comments:
*required field
Nuggets of Gold Retreat
Registration Form
Please fill out one form per individual.
When you have completed registration, you may pay by credit card below or
send registration fee by mail.
Overnight,  
All meals paid
$68.00*
1 meal
$9.00
2 meals
$17.00
3 meals
$25.00
4 meals
33.00
1 kids meal
$6.00
2 kids meals
$11.00
3 kids meals
$16.00
4 kids meals
$21.00
* Internet Service Fees Included