Roots Retreat 2017 : July 7 - July 9
Early Bird Registration (March 27, 2017 - April 30, 2017): $150 per student

Regular Registration (May 1 - May 15, 2017): $175 per student

Open Registration for non-CBC students (May 16 - June 30, 2017): $175 per student

Cost includes transportation, meals, t-shirt, and activities. Please don't let finances be an issue. Contact Jason (jawang35@gmail.com) about payment plans or available scholarships.

Once registered permission slips, liability forms, and a PaySimple invoice will be sent to you for online payment
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Student's Last Name *
Student's First Name *
Student's Birthdate *
MM
/
DD
/
YYYY
Student's Cell Phone Number *
If your student does not have a cell phone number, put N/A.
Father's Name *
LAST NAME, FIRST NAME
Father's Phone Number *
Father's Email Address *
Mother's Name *
LAST NAME, FIRST NAME
Mother's Phone Number *
Mother's Email Address *
Home Address *
T-shirt Size (adult unisex) *
Special Accommodations Needed *
If your student does not have any, put N/A.
Allergies/Intolerances *
If your student does not have any, put N/A.
Questions/Comments
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