Providence Point Retreat

Thank you for registering for our Emotional Healing Retreat. We are honored to have you with


us and truly feel that this is going to be a great weekend. Our text for this retreat is Psalm 34:18-19:

18 The Lord is close to the brokenhearted
    and saves those who are crushed in spirit.

19 The righteous person may have many troubles,
    but the Lord delivers him from them all;

We are believing God that life changing deliverance will take place.

Please complete the form below, this information will help us to better prepare to help you.

Retreat Guest's Profile
Please provide us with your first and last name.
Please provide an email address where you can be contacted confidentially.
Please provide a confidential telephone number where you can be contacted.
Please provide us with the first and last name of your spouse.
What is it that you are asking God to do in your life through this retreat?
What was the marital status of your parents during your preteen years?
Please indicate if you or other family members have been involved in any of the following occult practices.
Please check which of the following challenges are currently impacting your life.
Please give a brief description for each of the areas selected above.
Please give the names and telephone numbers of two emergency contacts and their relationship to you. They must be at least 18 years old.
Please list all food allergies so that we can better prepare to serve you at the retreat.


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