Serra Retreat
Hispanic Mens' Retreat
May 09 - 11, 2008
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:
____________________________________________________ |
|
Day Phone: _______________________ Eve Phone: ______________________ |
| Amt. Enclosed:
_________________
Check No: _________________________
Credit Card No: _______________________Expiration Date: ________________
|
| |
|
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 |