Group 30

Dave Larson is the coordinator of Group 30. If you need to cancel your retreat, please contact him.

Registration is limited to 72 men. Dave does use a waiting list. Please indicate on your request if you would like to be on the waiting list.

Name(Required)

First Last Suffix

Have you attended a retreat at Demontreville before?(Required)

Yes

Birthdate(Required)

Month

Day

Year

Do you have a change of address?(Required)

Yes

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred Phone(Required)

Phone Type

Home

Cell

Business

Do you give us permission to text?

Yes

Dietary Needs Accommodations(Required)

*Please email kitchen@demontrevilleretreat.com with your specific needs.

None

Gluten Free/Celiac

Dairy/Lactose Intolerant

Diabetic

Heart Healthy

Peanut Allergy/Sensitivity

Tree Nut Allergy/Sensitivity

Shellfish Allergy/Sensitivity

Fish Allergy/Sensitivity

Other

Food or Medical Allergies(Required)

* If yes, please note the allergies below.

None

Yes

Food/Medical Allergy Information(Required)

Please enter your food or medical allergy details beow.

Emergency Contact(Required)

First Last

Emergency Contact Phone Number(Required)

Additional information or requests :

This field is for validation purposes and should be left unchanged.