Since each retreat will be limited to a certain number of participants, those desiring to attend will need to send a $500 check guaranteeing their spot. That check will not be cashed, and will be returned to you at the conclusion of the retreat. Our intent is for this event to be cost-free, and the deposit is intended to prevent no-shows or early departures. If emergency situations arise that will prevent you from coming, please notify us as soon as possible. We will reschedule your retreat or return your deposit. The only situation in which your check will be cashed is if you fail to attend the retreat and do not notify us or if you leave the retreat early.

To register for a Spark of Life Retreat, fill in the information below. Mail your $500 (couple or individual) deposit check to:

Spark of Life Foundation
P.O. Box 1381
Searcy, AR 72145

Your Contact Information

Your Name:

Names of Family Members attending with you:

Street Address:

City, State:

Zip:

Email:

Cell Phone:

Work Phone:

Home Phone:

Names of Others Attending Who Live at Different Addresses –

Please have those attending with you who live at different addresses (friends or relatives) fill out their own registration form, and send their $500 deposit check as well. For those attending with spouses or children who are living in your home, one registration form and one deposit check are sufficient.

A reminder – The $500 deposit check will NOT be cashed, and will be returned to you at the conclusion of the retreat. The only exceptions are if you do not attend the retreat and do not let us know, or if you leave the retreat early.

Relative or Friend

Which friend or relative, who knows you are coming, and who are NOT coming to the retreat, could we call for further assistance? Please notify this person in advance that you are attending this retreat.

Name:

Relationship to you:

Phone:

Email:

Select Your Retreat

Please select the date(s) you prefer to attend. Retreats may fill up early. If you can attend
on more than one date, please let us know by ranking your preferences.

Retreat Option 1: Resource id #105May 31-Jun 3, 2012 | Grief Recovery Retreat Aug 9-Aug 12, 2012 | Grief Recovery Retreat - RESERVEDOct 11-Oct 14, 2012 | Grief Recovery RetreatNov 1-Nov 4, 2012 | Grief Recovery RetreatDec 6-Dec 9, 2012 | Grief Recovery Retreat

Please select your first option of the retreat dates.

Retreat Option 2: Resource id #124May 31-Jun 3, 2012 | Grief Recovery Retreat Aug 9-Aug 12, 2012 | Grief Recovery Retreat - RESERVEDOct 11-Oct 14, 2012 | Grief Recovery RetreatNov 1-Nov 4, 2012 | Grief Recovery RetreatDec 6-Dec 9, 2012 | Grief Recovery Retreat

Enter your second retreat option.

Retreat Option 3: Resource id #143May 31-Jun 3, 2012 | Grief Recovery Retreat Aug 9-Aug 12, 2012 | Grief Recovery Retreat - RESERVEDOct 11-Oct 14, 2012 | Grief Recovery RetreatNov 1-Nov 4, 2012 | Grief Recovery RetreatDec 6-Dec 9, 2012 | Grief Recovery Retreat

Enter your third retreat option.

Your Loss Experience:

Please briefly describe your reason for desiring to attend. This will help us to better prepare for your retreat experience.