VIP Gathering Registration

Restore Moms Retreat

Contact Details

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you an Unplowed Ground VIP Member(Required)

Yes

Lodging Selection(Required)

What level of care are you currently in?(Required)

ICU (Intensive Care Unit)

Hospital Room

Traditional Parenting

At different levels with different children

Overall, how are you doing?(Required)

I’m doing well!

I am doing okay.

I am really struggling.

I am in crisis

T-shirt size(Required)

Do you have any food allergies? If yes please specify.(Required)

Have you been to a VIP Gathering before?(Required)

I understand that the VIP Gathering is a very personalized event meaning that each and every registrant is thoughtfully prepared for. Our ministry spends time and money buying food and supplies for each and every attendee in advance.(Required)

I understand that by submitting this registration, I am making a commitment to attend the Fall 2024 VIP Gathering. (Please Initial Below)(Required)

I agree to give at least 14 days notice if I am unable to attend. (Please Initial Below)(Required)

For over 15 years, we have worked with hundreds of children with suffering from the effects of childhood trauma. At Unplowed Ground, we will empower you with strategies to move your child toward a more secure attachment.

VIP Gathering Registration

Restore Moms Retreat

Contact Details

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