Online Registration

Please complete the form below to register for Refresh Retreat 2012.

First Name
Surname
E-mail Address
Age	16-17 18-25 26-35 36-50 51-65 66+
Street Address
Suburb
Postcode
Phone
Mobile
Name of church (if regular attender)
Where did you hear about Refresh?:

Registration	Full payment of $390
	I'd like to help sponsor others to attend Refresh. If applicable, name of person/s: Amount of donation:
Payment Type	Visa - pay over phone 02 8678 0279 Mon, Tues, Thurs, Frid Mastercard - pay over phone 02 8678 0279 Mon, Tues, Thurs, Frid Cheque - payable to Refresh Retreat, post to PO Box 231, Castle Hill, 1765 Cash EFT Request - BSB - 012370 Account number - 1851-49417
Notes

	Cancellation Policy: Full refund available prior to 1st April 2012, transferable only after this date. Optional workshops and their pricing will be available through the Refresh Retreat Guide sent to you after April 2012. Full terms and conditions and explanation of inclusions please refer to www.refreshretreat.com.au Note : Rooming and dietary requirements will be coordinated closer to the retreat date.