Registration Form

If registering before December 1, the deposit is $50. After December 1, it’s $100. The total cost of the retreat is $300 (early bird) or $350 (regular rate). If you attend a Free Will Baptist church in Illinois, the State Christian Education Board will provide a $100 scholarship, bringing fees down to $200 or $250 respectively.

Please complete this form and pay the required deposit online here or by check (mail to JCity Center, 504 E. Broadway Blvd., Johnston City, IL 62951). You may also download pdf copy of the form to print and mail in with your check.

Space is limited to 12 couples. Your reservation will not be secured until we have both your registration form and payment.

For a full-screen version of this form, click here.

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