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Waitlist Form

If the Encounter dates you would like to attend are full, please fill out the waitlist form and indicate the dates you would like to attend.  Someone will reach out to you if a spot opens up.  

Birthday
Month
Day
Year
Shirt Size (Adult)
What category encounter are you singing up for?
Mens
Womens
Marriage
Youth or Parent/Youth

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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