Your Name:

Your Email Address:

Group or Organization:

Phone Number:

What dates will you be needing the Retreat Center?

How many days will you be staying at the Retreat Center?

How many nights will you be staying at the Retreat Center?

Estimate of the number of people attending your event:

How many meals will you need to have served by the Retreat Center?
(Please enter the number by days meals are cooked not number of people eating)

Breakfast

Lunch

Dinner

During your stay at the Retreat Center will you need the use of any of the following?
 Conference Center Large Meeting Space
 Conference Center 3 Break-out Rooms
 Mays Auditorium
 Swimming Pool
 Camp Fire
 Frisbee Golf
 Zip-Line
 Giant Two Man Swing

Do you have any other questions or comments about your stay at High Plains Retreat Center?

Thank you.