Waiting List | Chickens in the Road

A Hands-On Experience
in the
West Virginia Mountains
September 13th-15th
at
Camp Sheppard, located in
Roane County, West Virginia.
2012 Party on the Farm follows
on September 16th at
Sassafras Farm.

* * * The waiting list form may take a moment to load. Please be patient. * * *

CITR Retreat Waiting List

Please complete the form below to be placed on the Waiting List.

If an opening becomes available, those on the waiting list will be notified in order.

All information provided will be used for CITR Retreat 2012 purposes only. Your information will not be shared, sold, or used for any other purpose. * Please fill in all fields. They are all required.

I am 18 years of age or older.*
- Yes
Reservations are only open to those 18 years of age and older.
Personal Information
Name*
FirstLast
Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone*
Email*

Main - CITR Events
Questions? Contact me at CITRevents@yahoo.com.

CITR Retreat Waiting List

Personal Information