River Region Couples Retreat 2026 Register for the River Region Couples Retreat: January 23 - 25th, 2026 CommentsThis field is for validation purposes and should be left unchanged.Primary Contact Name(Required) First Last Cell Phone(Required)Do we have permission to contact you via text or phone regarding this event?(Required) Yes No Primary Contact E-Mail(Required) Secondary Contact Name(Required) First Last Secondary Contact E-Mail(Required) Home Congregation(Required)Billing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this your first time attending?(Required) Yes No Agreement(Required) I understand that I can receive a full refund up to 30 days before the retreat's start date. If I cancel my registration within 30 days of the retreat, a $100 non-refundable fee will be retained to cover fixed expenses associated with my registration.Payment Type(Required) Pay by Debit/Credit Card I have a promotional code Promotional Code(Required)Please make checks payable to Faulkner University. Down Payment Required ($100)(Required) Pay Full Amount (Yes) Pay Down Payment ($100) I have paid the down payment and would like to make an additional payment toward registration add_filter( 'gform_field_validation_101_22', 'donate_minimum_validation', 10, 4 ); function donate_minimum_validation( $result, $value, $form, $field ) { $min_amount = 25.00; $donated = str_replace('$', '', $value); if ( $donated < $min_amount ) { $result['is_valid'] = false; $result['message'] = 'A minimum amount of $'.$min_amount.'.00 is required to reserve your spot.'; } return $result; }Pay Down Payment Price: Registration Fee Price: Remaining Registration Amount Due **This option is only available for those who have already paid the down payment and would like to make additional payments toward their registration. A payment of less than $100 before the deposit is made does not guarantee a completed registration. Total Total Total Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name Your promo code was incorrect. Please try again. 2026 Retreat Schedule and Additional InformationRiver Region Couples Retreat Skip back to main navigation
