Fall Retreat Application

Name *
Address *
Phone *
How did you hear about the Eden Retreat?
Check all that apply
I have accepted Christ as my personal Lord and Savior, and I consider myself a Christian.
Please describe your relationship with God and how you entered that relationship.
Timing *
Please let us know how long it's been since your last miscarriage or stillbirth.
Examples: "I've had 3 miscarriages in the last 7 years, all first-trimester losses "Jan '17 at 27 weeks"
Grief *
Please check all that apply. This helps us best prepare and plan for you, but these answers will not be used for or against you in the selection process.