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Heroes Reflect Encounter
Registration Form

Check in time on Wednesday is 5:30-6:00 PM in Big Rapids.  The encounter will end Sunday early afternoon.  More details will follow in the email you provide on this form.  

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Cost of the Heroes Return Encounter is $50.00.  The full payment is due upon signing up unless other payment arrangements have been made.  

Participant Details

Multi-line address
Are you being sponsored?
Birthday
Month
Day
Year
Adult Shirt Size
This encounter is specifically for Military Members/Veterans, First Responders, Firefighters, and Law Enforcement/Police personnel. You must select at least one category to attend this encounter. If none apply, this is the wrong encounter.
Select the date you wish to attend encounter

Release & Waiver

By submitting this agreement, the undersigned desires to participate in various retreats programs, events, and activities operated by Theroadmap Inc. and The Broken Wheel Ranch Ministries.


The undersigned acknowledges that participation may incur personal injury or bodily damage and that The Road Map Inc and Broken Wheel Ranch Ministries will not allow participation without releasing and holding harmless The Road.


Further the undersigned agrees to hereby release and forever discharge The Road Map Inc their officers, directors, employees, agent, volunteers, and property owners of The Broken Wheel Ranch Ministries from all actions, claims injuries damages, cost, or expenses related to any activity in which the undersigned participates.


Is the participant under 18 years old?

Payment Options

Heroes Road Home Payment Options
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