Poiema Retreat Registration

Please fill out all boxes and remember that your space is not reserved until you have paid. The payment button will appear at the bottom of this form once you have completed all required information. Stay tuned to social media for announcements and please send any registration questions to Allie Couper (allie@terranovachurch.org). Thank you and we look forward to spending time with you at the retreat in Cavendish, VT!

A Little About You
Name*
First Last
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Emergency Contact Name*
First Last
Emergency Contact Phone*
Do you have any allergies (especially food allergies) that the retreat organizers should be aware of?
Scholarship Fund Donations
We want as many ladies as possible to go on this retreat. Some may have a difficult time finding $150 in their budgets at this time. Donations to the Retreat Scholarship Fund are tax-deductible. If you haven't already, you can give to the Scholarship Fund HERE If you have made a donation, or plan to, please let us know how much you've donated so we can plan accordingly.
Please indicate how much you plan to donate to the Scholarship Fund:
Financial Assistance
Please send an EMAIL to request a retreat scholarship. Funds will be awarded to women based on availability and need as we hope to assist as many ladies as we can. Thank you for your patience and understanding.
Registration Payment
NOTE: The retreat registration primarily covers two nights of lodging and all the food and beverages. Once you click on the "Submit" button below you will be redirected to Terra North Adams' Planning Center account to complete your registration/payment process.

Poiema Retreat Registration

A Little About You

Scholarship Fund Donations

Financial Assistance

Registration Payment

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