Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Colorado Beyond (Cabins) - August 13th 3p - 15th 5p, 2026 Event Fee *Price: $198.00 General Info Name *FirstLastEmail *Phone *Billing Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeI certify that I am at least 18 years old *YesBirthdate *Gender *Please Choose OneMaleFemale Dietary Restrictions & Medical Info Do you have any food or dietary restrictions? *YesNoPlease list restrictions and what types of food you can eat *Emergency Contact *FirstLastEmergency Contact Phone *Emergency Contact's Relationship to Attendee *MedicationsPhysician NameFirstLastPhysician PhoneMedical Insurance CompanyMedical Insurance Policy Number Indemnity Agreement I will not hold or attempt to hold Reclaim Ministries, Inc. liable for any loss, damage or injury to person or property caused by any act or neglect of other persons during the event or on or about the Property, or caused in any manner other than the willful or negligent act of Reclaim Ministries, Inc, its agents and employees, and will indemnify and hold harmless from any liability for damages or claims against Reclaim Ministries, Inc. arising out of or in any way related to any such loss, damage or injury. I release Reclaim Ministries, Inc., including its board members, volunteer staff, employees and agents, from my physical injury, including death, or illness during the event or while at the Property. I will assume the risk associated therewith, whether known or unknown to me at this time. This release is also intended to include all claims of my family, estate, heirs, personal representatives or assigns. Authorization for Treatment I hereby give permission to the medical personnel selected by the event director to secure and administer treatment and to maintain and/or release any medical records necessary for insurance purposes as outlined under the HIPAA regulation, and to provide or arrange necessary related transportation for the above named person. I verify that I am in good health and am capable of participating in strenuous activities, and when necessary, will tailor my activities to those within the bounds of my physical health. I agree and confirm that my health insurance and/or I am personally responsible for the expense of any medical treatment that is provided to me while attending a Reclaim Ministries, Inc. event. Cancellation Policy The event registration fee will be charged in full at the time of registration and includes a 50% non-refundable deposit. You may transfer your entire registration fee to another event or individual if needed but it must be used within 12 months or you will forfeit the entire registration fee. If you cancel your registration less than 2 weeks prior to the event you will forfeit the entire registration fee. If an event is cancelled by Reclaim, your entire event registration fee will be refunded in full. Consent *I accept the terms of the Indemnity Agreement & Authorization for Treatment formWhat's the name of the person you are connected with in Reclaim? * Payment Info Coupon Code Apply Please enter coupon code and click "Apply"Total$0.00 Credit Card * Submit
