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Young Men's Road Home Encounter Registration Form

This encounter is for Young Men, ages 14-17

Encounter Date: June 23-27, 2027

Check in time is on Wednesday from 5:30 - 6:00 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)​

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. 

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**Scholarships are available if needed, please contact Eric at eric.theroadmap@gmail.com

Participant Details

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

This Encounter has a special project that requires someone close to you such as a spouse, family member, or friend, etc. This person can be the same as the emergency contact but needs to know you well and someone who is not attending the encounter with you.

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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Payment Options

Young Men's Road Home Payment Options
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