CBFVA Fall Retreat "*" indicates required fields Step 1 of 3 33% Contact DetailsChurch Name* Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Registrant Name* First Last Email* Phone*Are you the Group Leader?* Yes No Group Leader NameIf different from above First Last Group Leader EmailIf different from above Attendee DetailsNumber of Students*Number of Adult Chaperones* Payment DetailsPayments, Adjustments, Cancellations and Refunds*•A 50% deposit is required at the time of registration, with the remaining balance due upon arrival onsite. •Payments can be made online using a credit card or by mailing a check to CBF Virginia, PO Box 425, Midlothian, VA 22321. •Online payments may be subject to an added online payment processing fee of 2.9% •Additional participants can be added at any time, subject to space availability. •Any changes to registrations or group cancellations must be submitted in writing via email to office@cbfva.org. •All payments are nonrefundable. I agree to the Payments, Adjustments, Cancellations and Refunds policy.Deposit Amount QuantityA 50% deposit per person is required at the time of registration. Price: $47.50 Quantity Full Amount QuantityYou may choose to pay the full registration price now. Price: $95.00 Quantity Total Payment Preference* Check Credit Card Credit Card Check PaymentPlease be sure to send in your check to CBF Virginia at PO Box 425, Midlothian, VA 22321. Δ
