Men's Retreat 2006
Booking Form

A Ministry of

Bible Baptist Church, Ballincollig, Cork
Pastor Craig Ledbetter
29 Westcourt Heights, Ballincollig, Cork, Ireland
Tel: 087-2766764   craigled@iol.ie   www.biblebc.com

This is a spiritual retreat for men and their sons. This form must be filled out by every adult who is coming. If someone (i.e. a teenager or child) is coming without their father, they must have their parent's permission and signature at the bottom of this form. Print out this form, and then post it to the address above.

NAME: ________________________________   AGE: _______  TEL: _______________________
ADDRESS: _______________________________________________________________________
YOUR CHURCH NAME: _________________________________________________
CHURCH ADDRESS: ______________________________________________________________
PASTOR'S NAME: ____________________________________

ARRIVAL DATE:  __________________  APPROX ARRIVAL TIME: _____________

CHILDREN COMING WITH YOU:

NAME: ________________________________   AGE: _________
NAME: ________________________________   AGE: _________
NAME: ________________________________   AGE: _________
NAME: ________________________________   AGE: _________
NAME: ________________________________   AGE: _________
(If there are more coming with you, please fill out an additional form)

COSTS: 30 per person, 20 for under 12's
PAYMENT:

        [___]  I have enclosed a check for ____________________
        [___]  I will bring monies to pay for my/our costs when I arrive in Killarney

YOUR SIGNATURE: __________________________________  DATE: __________________

IF A CHILD UNDER 18 WANTS TO ATTEND WITHOUT THEIR PARENT

"My son _______________________________ has my permission to attend the 2006 Men's Retreat being held in Killarney, Co. Kerry, and will be in the care of ________________________________________ during his time at the Retreat. If there are any medical emergencies, please contact me at (my mobile number) ______________________, and you have my permission to take him to the A&E of a local area hospital for treatement."

PARENT'S SIGNATURE:  ______________________________  DATE:______________

19 Jan, 2006 - Bible Baptist Church, Ballincollig, Cork, Ireland - www.biblebc.com