2022 Oak Grove Women's Retreat - Jan 14th-16th (Please complete by Jan 1st).

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* 1. Name

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* 2. Please check to affirm that you are fully vaccinated.

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* 4. If willing to drive others, please indicate the # of passengers you can take (not including yourself):

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* 5. I can leave anytime after:

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* 6. Special needs (dietary, mobility):

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* 7. Request for roommate:

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* 8. Accommodations - Leaning Tree with two to a room and semi- private baths, bedding and towels included. Cost is $120, but some scholarship funds are available. Please indicate if your attendance depends on this assistance (or contact Sue Greimel 612 805-2896, sue.greimel@gmail.com):

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