Shalom Retreat Center Group Registration Form Group Information Lodging/space usage Payment information Chapel A/V Equipment ($100 fee) Group/Individual Name * Arrival Date and Time * Departure Date and Time * Number of Attendees * (###) ### #### Overnight Spaces Reserved * (###) ### #### Meeting Spaces Reserved * (###) ### #### Meal Locations Reserved * (###) ### #### Other forms filled out and submitted? * Facility Use Agreement Release Form Date Deposit Was Made * Name Deposit Was Made Under * Form of Payment * Cash Check Credit Card Other Will Chapel A/V Equipment be needed * Yes No Additional Notes or Requests Completed By * First Name Last Name Thank you!
