Grassroots Summer Retreat Registration Form

Grassroots Summer Retreat 2017 Registration Form
When: September 1-3, 2017Place: Aurora Lutheran Bible Camp (Warnica Lake East)Contact:
1. Name:*
2. E-mail:*
3. Phone:
4. How many family members are you registering (over age 3)?*
5. Please list names of each family member, including yourself, separated by a comma:*


The campground has cabins that can hold 57 people:

  • Cabin 1 - no more than 12 occupants
  • Cabin 2 - no more than 7 occupants (3 in side A, 4 in side B)
  • Cabin 3 - no more than 16 occupants
  • Cabin 4 - no more than 10 occupants
  • Cabin 5 - no more than 9 occupants
  • Staff cabin - no more than 3 occupants
6. Do you require a cabin for your party?*
7. Please list any food restrictions in your family that we need to be aware of.
8. Please list any accessibility issues we need to be aware of.


Grassroots will cover the majority of the costs associated with the retreat, including the rental and food. However, if you can, please consider making an offering of $15 per person or $50 per family to offset some of the costs. If you cannot make this offering, please still come. This is why we pool our resources together as a church; to make something like this possible for all who can come.

Also, this form is confidential and will not be shared with anyone beyond the Educational Events team (those running the retreat).

9. Amount I am able to donate:
If you're making a payment online, you will be taken to PayPal to process payment after clicking Register below. Otherwise, please bring your cheque/cash to Steven Bill or Heather Denis at church!