2020 Crossway Thrive Winter Retreat
Friday January 3rd to Sunday January 5th, 2020 | Please fill out this form and click submit.
Our Crossway Irvine Thrive Youth Group Winter Retreat will be on Friday January 3rd to Sunday January 5th at a beautiful home in Oceanside. Cost is $125 per student. Your registration fee covers the retreat costs, meals, room, and travel.
Student Name
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Gender:
*
Please select one option.
Male
Female
Grade:
*
Parent/Guardian Name:
*
Email
*
This address will receive a confirmation email
Phone
*
Emergency Contact Name and Relationship:
*
Emergency Contact Phone No.
*
Address
*
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Any health concerns or allergies? Please reply 'none' if applicable.
*
Registration Fee:
$125.00
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Friday January 3rd to Sunday January 5th, 2020
Please fill out this form and click submit.
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