PERSONAL INFORMATION
Name:
Phone:
E-mail:
Address:
Gender:	Male Female
Small Group Name:
Emergency Contact
Name:
Phone:
TRANSPORTATION
PLEASE NOTE: Transportation to the retreat center will be arranged through small groups. If you have questions or need to make other transportation arrangements, please contact Moses Lee (moses.lee@hmcc.net).
PARTICIPANT LIABILITY WAIVER
I, the undersigned, will not hold HMCC and its drivers liable for any accidents, injuries, or damage to myself or my belongings during the retreat (from the time I depart the departure location until the time I return). This applies to me both as a participant and as a driver, if I choose to drive others to the retreat. Entering your name and date mean you agree to the terms of the waiver. Your registration will not be accepted without this section filled.
Name:
Date:
PLEASE NOTE: Submitting form will take you to payment through Google Checkout.