This is a sample form. When seminars are scheduled the form will have dates listed where question marks now appear.

Threefold Cord Ministries
Marriage Connections
Registration Form

Set sail on beautiful and serene Lake Powell

Name:_________________________________________________

Address:_______________________________________________

City:____________________________St:______Zip:____________

Phone:_____________________Wk Phone:____________________

Arrive the night before and needing the lodging and meals package?
Yes_____ No_____

With registration enclose $500.00 deposit in check, money order, or through paypal (paypal.com) account (docjohnbauers@hotmail.com). Balance due by (date here will depend upon when seminar is scheduled).
Cancellation policy determined by houseboat rental guidelines. Inquire for more details.

After the retreat you will receive a tax-exempt receipt for a portion of the cost as a charitable donation up to $500.00. Exact amount will be determined by the number of participants and the overhead of the retreat. Mail to:

Threefold Cord Ministries
16216 Windsor Creek Drive
Monument, CO 80132 Phone/Fax 719-488-4673