Registration Form | QuietWaters Ministries

Your Information

Cell Phone*

Secondary Phone

Spouse's Information

Spouse's Cell Phone*

Spouse's Email*

Church/Organization Information

Name of Your Church/Organization

Denomination

Intensive/Retreat Information

Please select the type of Intensive/Retreat:

Presenting Problems?*

Additional Information

Preferred Start Dates

Programs begin with Sunday arrival and conclude after lunch on Friday.

First Choice*

Second Choice

Preferred Start Dates (Spiritual Formation)

One-week Spiritual Formation Intensives begin with Sunday arrival and conclude after lunch on Friday. 3-day Spiritual Formation Intensives can be scheduled either Sunday through Wednesday or Tuesday through Friday.

First Choice*

Second Choice

Preferred Start Dates (Telehealth Spiritual Formation)

Our Telehealth Spiritual Formation Retreats are scheduled Monday through Friday. 3-day Telehealth Spiritual Formation Retreats can be scheduled either Monday through Wednesday or Wednesday through Friday.

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Second Choice

Preferred Start Dates (Telehealth Intensive)

Our Telehealth Counseling Intensives are scheduled Monday through Friday.

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Second Choice

Dietary Needs

A volunteer Host Couple will prepare your meals while you are at the Retreat Center. We strive to provide well-rounded, nutritional meals. Please let us know if you have any food allergies or medical dietary needs. We must know ahead of time, as there is a set menu. We will do our best to accommodate your needs during your stay, but please be aware that the Host Couple is preparing meals for multiple guests and may not be able to accommodate special requests.

Please specify the person with allergies:

Food Allergy Details:

Please specify the person with allergies:

Medical Dietary Needs Details:

How did you hear about QuietWaters?