Womens Women's Retreat Signup If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required 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. 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 April 6-8 (Wait List, do not pay)April 20-22 (Wait List, do not pay)May 4-6 (wait list do not pay) Special Food Requirements 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.