1645 Colborne St. E, Brantford, ON, N3T 5L4
Phone: (519)754-0171 Fax: (519)754-5490
Retreat Information Form
Please fill out the following information to start the booking process for your retreat. Submitting this form does not guarantee your booking. If the date you are requesting is available the Retreat Coordinator will send you a contract and confirmation once your deposit has been successfully processed. This form and a
are necessary to reserve your retreat. Your retreat will not be considered booked until you have received your retreat contract.
Name of Group
Type of Group
Phone Number of On-Site Contact (If different than above)
Address Line 2
Approximate #'s (min of 50 people required to book Jackson Hall)
(min of 20 people required to book the Lodge)
Requested Retreat Dates
Full weekend in Jackson Hall
Full weekend in the Lodge
Full weekend in cabins
If you checked "other", please specify:
Standard Check-In/Check-Out Times
5pm or later
9am or later
If your group requires Check-In/Check-Out times that are different from our standard times please indicate your prefer times below.
Requested Arrival Time
Requested Departure Time
Please indicate your preferred method of payment for the
retreat deposit. Please note that your credit card will not be processed immediately. The Retreat Coordinator will process the deposit once the information form has been processed.
Credit Card Payment Information
Name on Card
Credit Card Type
Credit Card Number
Expiration Date (mm/yy)
Name of Cardholder
Jackson Hall Groups Only
We will require a second deposit of $750.00 one month prior to you retreat.
Would you like us to use the credit card number provided to process the second deposit as well?