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Retreat Application

Name First Last
Gender
Will you be attending as a couple?
Email
Phone (###-###-####)
Cell Phone (###-###-####)
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name of Sending Organization or Church
Denomination (if applicable)
Retreat dates for which you are applying
Number of adults attending, and ages of adults.
(Please remember that there is an additional charge for childcare, dependent upon the number of children)
Names and ages of children who will be attending
Is childcare being requested?
Are you planning on using insurance?
Specific needs or goals in attending the retreat
Are any prospective participants currently suffering with suicidal thoughts/tendencies which are not currently under control with medication?
Are any prospective participants currently experiencing psychotic symptoms which are not currently under control with medication?
Is chemical/substance dependency or addiction a primary reason for seeking help at this time?
Are there any other special needs/issues of which we should be aware?
How did you learn about Alongside?

Once your application has been approved, we require a $500 non-refundable deposit to secure your place.

We are excited about the possibility of meeting you and serving you. Thank you for taking the time to answer these questions. Your answers to these questions will help us determine if we can be helpful to you or if you might be better served in some other way. In the event that ALONGSIDE determines that this ministry would not likely be significantly helpful for your needs, we will attempt to inform you of other caregiving options of which we are aware.

Alongside Inc.

Renewing and Equipping Christian Leaders

Apply Online

Retreat Application

Alongside Inc.

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