Women’s Registration | Refuge Foundation

Please don’t register until you have your Airline tickets. Email Laura Rembe with any additional questions. All trips are Monday through Thursday on these dates:

Jan 20-23
Jan 27-30
Feb 3-6
Feb 10-17

Feb 17-20
Feb 24-27
Mar 2-5
Mar 9-12

Mar 16-19
Mar 23-26
Mar 30-Apr 2

ABOUT YOU

First Name

Last Name

Spouse's Name

TRIP INFO

Refuge Trip
Start Date

Flight Arrival Date and Time into Billings, MT

Flight Departure Date and Time out of Billings, MT

ORGANIZATION INFO

Name of Your Organization

Street Address

Street Address 2

City

State / Province

Postal / Zip Code

Phone Number (include area code)

PERSONAL INFO

Street Address

Street Address 2

City

State / Province

Postal / Zip Code

Cellphone Number (Include area code — this needs to be the phone you will carry during your time at the Refuge Foundation)

FISHING INFO

Are you interested in fishing?

YesNo

If yes, do you need Refuge to provide you with a rod and reel?

YesNo

And, do you need Refuge to provide you with waders / boots?

YesNo

If yes, Shoe Size?

MORE INFO

Emergency Contact Name

Emergency Contact Phone Number (include area code)

Favorite Drink

Favorite Snack

Favorite Dessert

Favorite Way to Rest

Robe Size

How can we pray for you between now and your trip?

Any food restrictions we need to know of?

Any special needs we need to be aware of?

Comments

LIABILITY WAIVER

By checking yes below and clicking Register, I hereby release the Refuge Foundation and its officers and employees from any liability of personal injury, or loss or damage to personal property during activities associated and/or participated in while on my Refuge Foundation Adventure.

I acknowledge that I understand the waiver described above. Waiver is made to the maximum extent permissible under applicable law. I acknowledge that I have agreed to this under my own free will.

YesNo