- Adults (ages 12+) - Youth (ages 4-11). - Children under 3 years are free.
Ticket Type: Adult (ages 12+) $375Youth (ages 4-11) $360Summer Intensive Student $360
Name of Registrant:
Your Email Address:
Your Phone Number:
Your Gender: MaleFemale
Please list your prior Islamic Education.
Please indicate any MEDICATIONS/MEDICAL CONDITIONS (physical or psychological) that you have (such as the nature of the conditions and treatment plans, and/or storage requirements for medications, etc).
Please list/describe any DIETARY RESTRICTIONS / ALLERGIES that you have.
For allergies, please indicate the ALLERGY SEVERITY? (e.g. Would you go into anaphylactic shock?)
Please indicate any OTHER SPECIAL REQUIREMENTS that we should be aware of for you (e.g. elderly need; accessibility need; psychological need).
Name of Emergency Contact:
Emergency contact is your:MotherFatherBrotherSisterSonDaughterFriendOther
[group other] [/group]
Email Address of Emergency Contact:
Phone Number of Emergency Contact:
If you will be bringing any children (below the age of three) please list their ages and names.
Transportation (the day of the Retreat): How will you be arriving at Camp Muskoka?I will arrive at 9 AM on Thursday at the pick-up location and I will take the FREE bus to the camp.I NEED to bring my car to the camp. I have a legitimate reason and can pay $10/day for parking (NOTE: parking is limited).
If you need to take your car to the camp, please explain why. Parking spaces will be allocated on a first come first serve basis. SeekersGuidance reserves the right to reject requests for on-site parking due to the limited parking space.
Why do you want to attend the Retreat?
How did you learn about the SeekersGuidance Retreat?
I bear witness that the information contained in this registration form was filled out personally by the registrant and is accurate and complete, to the best of my knowledge.
Add Another PersonYes
[group other2] [/group]
Add An other PersonYes
Adult (ages 12+) $375Youth (ages 4-11) $360Summer Intensive Student $360
[group other3] [/group]
[group other4] [/group]
[group other5] [/group] Email Address of Emergency Contact: