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Cart
0
About
Donate
Offerings
Retreats
Offerings
Rest Boxes
Support Groups
Alumni events
Prayer
Resources
Respite Guest Room
Deeper Places Retreats
Retreat Waitlist
Blog
Volunteer
Recipe Book
Forms
FAQ
The Flower Shop
Contact
Testimonials
Respite Retreat Information Form
Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Travel Plans
*
Please detail below your travel plans: driving or flying (if you are flying please enter your flight details/arrival time as we may be able to coordinate rides from and to the airport for you).
Your Birthday
*
MM
DD
YYYY
Food Allergies
*
Favorite Color
*
Private Session
*
Please let us know if you would like a spiritual direction session with one of our spiritual directors or a prayer session with one of our leaders
Spiritual Direction
Prayer
Both
None
Number and ages of children
Marital Status
Married
Separated
Divorced
What kind of betrayal have you experienced?
As we pray over which small group leader will care for you for the next year, we would love to place you with someone who may have a similar experience. If you feel comfortable doing so, please check which area your partner/ex partner has acted out in. This will help us place you under the care of someone who may understand your particular experience.
Pornography use and/or addiction
Affairs/Infidelity
Same sex attraction/homosexuality
Prostitution/massage parlors
Other
All of the above
Anything else you'd like us to know
Thank you!
We are thrilled you have chosen to spend time with us and pray that your experience is one of deep nourishment, rest and encouragement on your journey.
