1645 Colborne St. E, Brantford, ON, N3T 5L4

Phone: (519)754-0171

retreats@csranch.ca - www.csranchgrandriver.ca

Retreat Information Form

Please fill out the following information to start the booking process for your retreat. If the date you are requesting is available the Retreat Director will send you a contract and confirmation information once your deposit has been successfully processed. This form and a $500 deposit 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 *

Youth

Church

Ladies

Other Other

Contact Name *

Phone Number *

E-mail Address *

Phone Number of On-Site Contact (If different than above)

Contact Address *

Address Line 2

Approximate #'s (min of 50 people required to book Jackson Hall)
(min of 20 people required to book the Lodge & Cabins)

*

Requested Retreat Dates *

2023 Pricing

2024 Pricing

Day Prices

$75.00/person with horsemanship
$60.00/person with NO horsemanship
$30/person -- does not include meals or program

Retreat Options

Facilities *

Day Group	Jackson Hall	The Lodge
Cabins

Length of Stay *

Day Only

1 Night

Full Weekend

Other Other

Program *

No Activities

Up to 4 Recreational Activities

Horsemanship + up to 3 Recreational Activities

Standard Check-In/Check-Out Times

Weekend: Mid-Week

Check-In: 5pm or later Check-In: 9am or later

Check-Out: Before 1pm Check-Out: Before 4pm

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

Retreat Deposit

Please indicate your preferred method of payment for the $500 retreat deposit. Please note that your credit card will not be processed immediately. The Retreat Director will process the deposit once the information form has been processed. *

Credit Card

Cheque

E-transfer

E-transfer Information: Send e-transfer to grandrivereft@csranch.ca, including your group's name in the message section.

Credit Card Payment Information

Name on Card

Credit Card Type

Credit Card Number

Expiration Date (mm/yy)

CVC

Name of Cardholder

Address

Jackson Hall Groups Only

We will require a second deposit of $750.00 three months prior to you retreat.

Would you like us to use the credit card number provided to process the second deposit as well?

Yes

No

Signature

clear

Date

Next Steps in the Booking Process

Once we have processed your information form and arranged deposit payment, we will send
you a retreat contract. Depending on your package choices, you will receive the following
information (only the things that apply to your specific retreat):

- General Information Package for your guests
- Menu Options and/or Allergies and Dietary Restrictions Form
- Program Request Form
- Horsemanship Waiver
- Hold Harmless and Insurance Information