Reflect Registration | The Road Map

Reflect Encounter Registration Form

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

Deposit to hold your spot is $249.00 and is non refundable. You may also select the pay the full cost of $449.00. The full payment is due 3 weeks prior to the encounter start date unless other arrangements have been made.

First name

Last name

Street Address

Street Address Line 2

City

State

Postal / Zip code

Phone

Birthday

Emergency Contact Name

Emergency Contact Phone Number

Relationship to Emergency Contact

Emergency Contact Email

Food Allergies

What is the name of your home church?

How did you hear about us? (If friend or church, please write the name)

Prayer Requests

Select an item ($)

Reflect Deposit (Non-Refundable) - $249.00

Reflect Registration - $449.00

Thank you for signing up for an Encounter. More information will be emailed to you.

Reflect Encounter Registration Form

3217 108th St SW Byron Center, MI 49315 Chuck- 616-291-6493 info.theroadmap@gmail.com

3217 108th St SW
Byron Center, MI 49315
Chuck- 616-291-6493
info.theroadmap@gmail.com