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Serra Retreat
Hispanic Married Couples Retreat
August 08 - 10, 2008
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Print this form and return with
a $50.00 non-refundable deposit
to Serra Retreat, P. O. Box 127, Malibu, CA 90265
| Name:
___________________________________________________________ |
| Address:
__________________________________________________________ |
| City:
____________________________________ State: ___
Zip: ____________ |
| Name of Parish:
____________________________________________________ |
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Day Phone: _______________________ Eve Phone: ______________________ |
| Amt. Enclosed:
_________________
Check No: _________________________
Credit Card No: _______________________Expiration Date: ________________
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I prefer a private room [ ]
Shared Rm [ ]
Name of Roommate: ______________ |
SUGGESTED DONATION: Private Room: $200.00; Shared room: $150.00
A confirmation phone call will be made upon receipt of deposit
Note: Private rooms are subject to availability
Special room requests cannot be guaranteed
Office: (310) 456-6631
FAX: (310) 456-9417
www.serraretreat.com