Spiritual Retreat Registration Form

October 17-19, 2025 (Friday - Sunday)

For Sponsorships please complete Sponsorship section below.

Registration Form

Name*

Email*

Mobile number*

Street Address and Number*

City, State and Zip Code*

I understand my registration is confirmed upon payment of $329.*

Adding a Day*
Yes, count me in, I need the break and want to come on Thursday October 16! (additional $39)No thanks, I'll see you Friday

Sponsorships

If someone is sponsoring you for this event, please provide their contact below so we can send forms of payment directly to them.
Note: Sponsorships of other people are tax-deductible donations to the non-profit 501.c.3
Name
Email
Mobile number

If you would like to request a Sponsorship for yourself, please email info@rootempowermentministry.org to receive a Sponsorship Request form.

Food Allergies (optional)

Your message (optional)

* I understand all paid registrations are non-refundable.

You will receive an email shortly with a link for payment.

*Registrations are confirmed upon payment
*All registrations are non-refundable

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