MILA Retreat Registration Form - May 2009
Welcome to the 4th MILA Family Retreat. Please use this form to:

1. Register yourself and those accompanying you (spouse and/or dependents).
2. Donate to the MILA Retreat fund to help us cover expenses - optional.
3. Make your payment online securely (credit card or check).

Note: if you have any questions, please feel free to contact us at retreat@milacolorado.org or call us at 303-884-7491.

First Name:
Last Name:
Gender:
Address 1:
Address 2:
City:
Zip:
State:
E-mail:
Phone:
Cell Phone:
Is your spouse attending?
Do you have dependents (all ages) who will attend?
If so, how many?