Relationship Retreat Registration FormRelationship Retreat RegistrationAugust 25 – 27, 2023 Cedar Crest Lodge Pleasanton, KS Guest 1 Name * First Guest 1 Last Name * Last Guest 2 Name * First Guest 2 Last Name * LastAddress Address Address Line 1 Address Line 1 Address Line 2 Address Line 2 City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Phone * Email * Married * Yes No How long have you been married or in a relationship? * What are the top two concerns in your relationship? * What do you hope to get out of this retreat? * Room Descriptions <p><strong>Tuscon Manor Suite $3750.00 </strong></p><ul><li>This spacious 1,200 sq. ft.</li><li>An oversized two-person Jacuzzi tub</li><li>A private bath includes a two-person shower</li><li>towel warmer</li><li>forced-air electric fireplace</li><li>dining table</li><li>two Smart TVs</li><li>Bluetooth speaker</li><li>small refrigerator</li><li>microwave</li><li>Keurig coffee maker,</li><li>double french doors lead to a 10 ft. x 24 ft. deck</li></ul><p><strong>Standard Suite $3500.00</strong> (amenities vary)</p><ul><li>king bed</li><li>sitting area with a fireplace</li><li>dining table</li><li>two-person tub and shower</li><li>heated towel bar</li><li>Smart TV</li><li>small refrigerator</li><li>microwave & Keurig</li><li>sunset views</li></ul><p><strong>Standard Room $2500.00</strong> (amenities vary)</p><ul><li>king or queen bed</li><li>tiled shower</li><li>amazing views</li></ul>Room Selection (price per couple) * Tuscan Manor Suite $3750.00 Standard Suite $3500.00 Standard Room $2500.00 Payment & Cancellation Policy <p><strong>Payment</strong></p><p>Reservation must be <strong>paid in full </strong> within 48 hrs of submitting form online. To make payment, please call Shana Bennet 620-365-8641 ext 208.</p><p><strong>Cancellation & Refund Policy</strong></p><p>To cancel and request a refund, you must request it in writing to Shana Bennet sbennett@sekmhc.org. You may receive a full refund if you cancel your registration prior to August 11, 2023. After August 11, 2023, no refunds are provided due to our contractual obligations.</p> Special Accommodations Request If you are human, leave this field blank. Submit
