Baruch HaShem Messianic Synagogue: Men's Retreat Registration

Men's Retreat Registration

Note: The name and e-mail fields below are required and must be filled out in order for your message to be sent.

Registration costs and deadline information are not yet available. Please check back for additional information.

Your First Name (Exact Name for Insurance Purposes):

Your Last Name (Exact Name for Insurance Purposes):

Emergency Contact Phone & Name:

Your Email Address:

Your Street Address:

Your City, State, Zip:

Your Home phone:

Your Cell phone:

Your Work phone:

Indicate your choice of roommates (list in order of preference) for a motel room:

Check here if you require a first floor room:

Check here to volunteer to Set up:

Check here to volunteer to mealtime set up/cleanup:

Check here to volunteer to tear down:

I need a ride:

I can offer rides for (how many?) other men.

(Note: The following indicates your intent to pay, you can not pay using this web page.)

Click here for single room registration ($75):

Click here for two sharing a room registration ($55):

Click here for Lodge registration ($35):

(Prices above include three meals!)

Click here for Zip Line ($15):

Any Comments and Questions:

Alternatively, you can fill out a paper sign-up form available in the lobby or from the office at Baruch HaShem.

You may call our office with any questions:
Our office telephone number is (972) 386-0121.

Office hours:
Monday - Thursday 10:00 AM - 5:30 PM
US Central Time

Copyright © 2005 - 2008 Baruch HaShem Synagogue

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