< Back to Retreat Page Registration 1 Your Info2 Room Options3 Notes & Total Your InformationName* First Last Phone*Email* Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Room OptionsI will have 3 roommatesI will have 2 roommatesI will have 1 roommateI am coming individuallyPlease choose an option:*I want a room to myself.Share with one other personI would like a bed on my own, but will share with 1 or 2 peopleI am coming alone, but would like to share a room of 4Please choose an option:*Me and two friend will share a roomWe would like to have a 4th person share our roomPlease choose an option:*I have a roommate that I would like to share a room withI have a roommate, but would like to have one or two more in our roomTell us who your roommates are:Please indicate who you will be staying with. If you are unsure of who you will room with, We encourage you to come back to this registration process at a later time or sign up as an individual registration and we can help you find a roommate.Roommate 1*Roommate 2*Roommate 3*Total $ 0.00 CAD Special RequirementsWe like to do our best to accomodate you during the weekend. If there is anything we need to know to help make the weekend great let us know here. (dietary restrictions, disability, nursing baby, etc.)Total $ 0.00 CAD Payment preference*If your selection for payment is PayPal, you will be redirected to PayPal's website to complete your transaction.ChequeE-TransferPayment PlanPlease send e-transfers to: email@example.com Please remember that you are not considered registered until you have sent payment in.Please send Cheques to: 1825 Rothwell Street, Regina, SK, S4N 2C3 Please remember that you are not considered registered until you have sent payment in.Please contact Rachel to set up a PAC plan: firstname.lastname@example.org Please remember that you are not considered registered until you have sent payment in.PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.