ALCRC-17-05-18 Great Hymns of the Faith Series

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*First Name *Last Name Address 1 City State Zip *Phone *Email
*Preferred FIRST name for name tag

Please type your FIRST name only, using appropriate upper and lower case letters. Name tags for your event will be generated directly from this entry, so please just type the FIRST name that you prefer people to use.

*Choose your session:

Save money by selecting the "Season Ticket Option" and paying for all three now! We do ask that you pay the registration fee in advance, either online (after you click "submit" you will be taken to a page where you can pay by credit card or by PayPal), or by mailing us a check--make the check out to "ALCRC" and put "Great Hymns" in the memo line; send to Collins Retreat Center, 32867 SE Highway 211, Eagle Creek, OR, 97022. If you register without paying in advance you will be asked to submit payment even if you do not attend the event, since your registration information on this form tells us to prepare program materials and food for you. Thank you!

Season Ticket (all 3 Great Hymns of the Faith events) ($45)
May 18, 2017 ($18.50)
August17, 2017 ($18.50)
October 26, 2017 ($18.50)
Season Ticket (all 3 Great Hymns of the Faith events): There are only 40 available
May 18, 2017: There are only 29 available
August17, 2017: There are only 30 available
October 26, 2017: There are only 37 available
*Do you have any specific dietary needs? (if yes, see below)
Dietary Needs

Please let us know about any specific dietary needs. Our staff is proficient in providing for diabetic, vegetarian, gluten-free, lactose intolerant and vegan diets, and we also have experience in working with many other dietary needs. If you make exceptions in your diet category (for example, you consider yourself "dairy-free" but you do eat butter) please let us know. We strive to meet all dietary needs of our guests as part of our ministry of hospitality.

Vegetarian or Pescatarian (indicate below)
Dairy-Free (please explain below)
Other (please indicate below)
*Do you eat fish and other seafood?
*Do you eat butter?
Description of any specific needs:

Use this space to further describe your dietary needs, or to note exceptions in your diet category.

Church Affiliation

Please indicate if you have an affiliation with a denomination.

United Methodist Churches

If you are affiliated with a United Methodist Church, please indicate which church.

Episcopal Churches

If you are affiliated with an Episcopal Church, please indicate which church.

Optional Donation to ALCRC ($1)

If you would like to make a donation to Alton L. Collins Retreat Center, please enter the amount of your donation - you can indicate any amount in the field, but do not include the dollar sign ($). Thank you!

Only number values are allowed
Other Considerations?

Indicate below if there is anything else we need to know in order to prepare for your arrival--for instance, you are bringing a nursing infant, or you use a wheelchair, or you need to bring medical equipment with you. It is easier for us to accommodate your needs if we know in advance. Thank you!

*I understand that my registration form is not complete unless I see a confirmation screen and receive a confirmation email.

If you have difficulty completing your registration form, please contact our program director at or call 503-637-6411. If you do not receive a confirmation, you are not registered for this event.

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