MensWomens If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Name (MAKE SURE TO FILL IN ALL FIELDS) PLEASE FILL IN Email PLEASE FILL IN Phone PLEASE FILL IN Membership AAAlanonBoth Emergency Contact Info PLEASE FILL IN Retreat you wish to attend PLEASE FILL IN Fall Sept 20-22, 2019Fall Oct 4-6, 2019Fall Oct 18-20, 2019 Saturday night dinner SteakSalmonBoth Please fill in your food allergy or type NONE Sleeping arrangements I need a bedRequest a bedNo bed needed Service Opportunities ChairSpeakerCookingCleanupTransportationFuture retreat service Please acknowledge you have read by checking the box which is required for your registration to be accepted Upon registration, a confirming email will be sent that provides the link to the Paypal page. Upon entering PayPal, please select "Send money to friends or family". eliminates PayPal Service Charge - retreat receives 100% of your payment. PLEASE FILL IN Donations are accepted through PayPal for LODI retreat scholarship fund. Give the gift of a retreat!! IF YOU HAVE NOT RECIEVED A CONFIRMATION EMAIL CHECK YOUR SPAM EMAIL BOX. IF YOU HAVE STILL NOT RECIEVED A CONFIRMATION EMAIL PLEASE RESUBMIT FORM TO BE SURE YOU HAVE RESERVED YOUR SPOT. REQUIRED QUESTIONS ARE IN RED. THESE MUST BE CHECKED IN ORDER FOR FORM TO SUBMIT DATA. Thank You! Women's Retreat Signup If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Registration for spring of 2019 opens Feb 16 1 .Fill out registration form and hit submit (below). 2 .After filling out the registration form you will be emailed a link from our auto response initiated after registering. 3. PLEASE register people individually. If you are registering someone else please use their information (phone and email) since we contact people before the retreat for service work. 4. The LODI Steering Committee request that any sober house members limit 6 retreat goers to any one retreat. If more that 6 would like to attend please divide up among the retreats so that no more than 6 are on any one retreat. PLEASE FILL IN ALL FIELDS - Please be sure to click the SUBMIT button on the bottom of the form. (In order to secure your spot, please pay $50 per person via Paypal using friends and family option to save the fee or mail a check made payable to and mail to Cindy Stark 8956 Larchwood Ct. St. Louis MO 63126) All fields with an * are required. If you do not complete a field or check a box, the form will not be submitted. Name* PLEASE FILL IN Email* PLEASE FILL IN Phone* PLEASE FILL IN Be sure to choose the date of the retreat you wish to attend. Choose Date of Retreat you would like to Attend:* YOU MUST PICK A DATE!! PLEASE FILL IN Sept 13-15, 2019Sept 27-29, 2019Oct 11-13, 2019 Special Needs Bed Request* PLEASE FILL IN I need a bed due to medical conditionsSleeping on a mattress on the floor is fineI cannot have a top bunk Program you participate in, This will help choose chair and speakers for meetings.* AAAl-AnonBothThis is my first time on a Woman's Retreat Emergency Contact Name & Number Check your email for payment link. All fees are non-refundable and added to the LODI fund if you cancel. Subscribe To OurEmail ListJoin our mailing list to receive the latest news and updates from our Lake of Dreams SUBSCRIBE! You have Successfully Subscribed!