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Asbury Sign-up Sheet for Leesburg Men's Retreat - October 22nd - 24th
Full Name:     Number of Reservations:      
YOUR Phone Number:               xxxxxxxxxx format
YOUR E-Mail Address:             
Your Street Address:             
Address 2:
City:                 State:                 Zip:             
   Name of Church:              

ACCOMMODATIONS:
I want to stay / eat at Life Enrichment Center (LEC):
I want to stay off campus: and eat at LEC:
I want to stay and eat at the Youth Camp;
   I want to stay at the campground: and eat at the LEC:
 I will attend Sunday only:

I want to ride in the Church Van, up and back:  YES     NO

I have a question:
For spam control enter the letters "SNEM":

Asbury's privacy policy promises:

  •  Any Information provided will NOT be used for any other purpose than to get you to come to Leesburg.

  • We will NOT give your e-mail address to anyone or any group, individual or neighbor.

  • We will NOT use your mailing or e-mail address as a means to send you literature or information.

  • We will not give your address to another UMM member without your express permission.

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Revised: August 14, 2010

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For more information on our programs, please contact us at 407 644-5222
or e-mail us at aumc@asburyumc.com.