DISABILITIES MINISTRIES RETREAT REGISTRATION FORM

Please make your $150 check payable to Allegheny East Conference, memo line should read: DISABILITIES MINISTRIES. Mail to: Allegheny East Conference, Attn: Patricia Lewis, 767 Douglass Drive, Boyertown, PA 19512

Registration deadline is Sept 15, 2019.

*PLEASE NOTE THAT ANYONE NEEDING ASSISTANCE MUST BRING SOMEONE TO HELP, AND THAT PERSON MUST ALSO REGISTER AND PAY
Name *
Name
Address *
Address
Phone *
Phone
Please note that the cabins are not wheelchair accessible or ADA compliant.