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Rise Encounter
Registration Form

This encounter is for Young Ladies, ages 14-17

Date: June 16-20, 2027

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Check in time is on Wednesday is at 2:00 PM in Big Rapids. The encounter will end Sunday early afternoon.

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*Deposit to hold your spot is $200.00 (deposit is non-refundable)

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Cost of the encounter is $349.00, the full payment is due 3 weeks before the encounter starts unless other payment arrangements have been made. ​

Participant Details

Multi-line address
Are you being sponsored?
Birthday
Month
Day
Year
Adult Shirt Size

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?
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Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Payment Options

Rise Payment Options
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