Registration Application

Preferred Weekend: *

January 27-29, 2012 - YMCA, Estes Park, CO

March 2-4, 2012 - Austria

June 1-3, 2012 - YMCA, Estes Park, CO

October 19-21, 2012 - Franciscan Center, Colorado Springs, CO

Please check which weekend you would like to register for.

Second Choice: *

January 27-29, 2012 - YMCA, Estes Park, CO

March 2-4, 2012 - Austria

June 1-3, 2012 - YMCA, Estes Park, CO

October 19-21, 2012 - Franciscan Center, Colorado Springs, CO

In case your preferred weekend is already full, please select your second choice.

First Name: *

Last Name: *

Date of Birth: *

Street Address: *

City: *

State: *

Zip: *

Primary Phone: *

sample format: 303-123-4567

Secondary Phone:

sample format: 303-123-4567

Email: *

Church:

Who do you know that will be on this weekend? (staff, attendees): *

Please list any women that you do not want to be in a group with:

This is a physically, emotionally, and spiritually challenging weekend. Please explain in detail any personal circumstances that we should be aware of. (example: heart disease, physical impairment, pregnancy, mental health diagnosis.) : *

Women's Walk With Christ is built on the Christian beliefs declared below. Do you agree with this statement of belief?: *

Yes

No

"We believe in God, the Father Almighty, Creator of heaven and earth; We believe in Jesus Christ his only Son our Lord. He was conceived by the power of the Hold Spirit and born of the Virgin Mary. He suffered under Pontius Pilate, was crucified, died and was buried. He descended to the dead. On the third day he rose again, He ascended into heaven, and is seated at the right hand of the Father. He will come again to judge the living and the dead. We believe in the Holy Spirit; the holy universal church, the communion of saints, the forgiveness of sins, the resurrection of the body, and the life everlasting."

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