LOMT 2012 Retreat Request Form

All required fields are marked with an*
Desired Arrival Date:*
Group Name:*
Mailing Address:*
City:* State:* Zip:*
Phone:* ( ) - Fax: ( ) -
Group Leader:*
Phone:* ( )-
E-Mail address:*

NOTE: If you do not have an e-mail, enter your first and last name in the e-mail field.

Estimated Group Attendants

Event Name
Number of Males Number of Females
Total Number of Attendees

Desired Meals Request

Date In Time In
Date Out Time Out
First Meal Last Meal
Total Number of Meals

Desired Lodging Request

Number of Nights

Check the types of lodging desired
Cabins
Retreat Center
Selah House

Desired Activities

Check the activities desired
Campfire
Challenge Course
Swimming Pool
Canoeing
Archery
Orienteering
Devotions
Walking Trails
Servant Project
Outdoor Games
Indoor Games
Astronomy