Pregnancy Abortion Adoption Post-abortion Healing Sex & STDs For Men Only About Locations
Search this site
 

Abortion: Hope Retreat Registration

Upon your confirmation we begin our plans for you. Please make all attempts to coordinate (work, childcare, personal appointments, and church commitments, etc) around the dates. We have a waiting list and hope to accommodate all who are interested.  

PLEASE NOTE:

Register here for:

    Hope Summits --   

 Abundant Life Christian Fellowship
 Jan 17 - March 6, 2012
 Cathedral of Faith
 Feb 7 - March 27, 2012
 WestGate Feb 2- March 22, 2012
 Venture
 Feb 23- April 12, 2012
 Mountain View (New Group)
 April 10- May 29, 2012
 

The HOPE Summit hosted by RealOptions are free of charge to attendees. 

Please indicate in the comments below which Summit location you would like to attend.

First Name *
Last Name *
Phone *
Email *
Address *
City *
Zip
How did you hear about the summit? *
Do you attend a church? Yes No
If so what is the name of your church? (not mandatory to have a church association)
How many abortions do you have in your past?
How long ago was your abortion experience(s)?
What do you hope to gain by attending the Hope summit?
What are some foreseeable obstacles for you attending the summit?
May we leave you a detailed message on the phone number you gave us? Yes No
What would you rate your emotional/spiritual health on a scale of 1-10?
Please explain your emotional/spiritual health?
Are you able to attend the full 8 week summit:? Yes No
Do you have any physical limitations to limit you from minor physical actions? Yes No
Will you have a friend or prayer partner to support you during this retreat? Yes No
Do you have a Bible? Yes No (If no, we can provide a Bible)
Are you currently in sessions with: a Professional, Lay, or Spiritual Counselor at this time? Yes No
Are you currently pregnant, going through fertility treatment or an adoption process? Yes No
All class discussion is confidential; will you have trouble committing to the anonymity? Yes No
Please share with us your birthdate (06/18/1966),
Comments
Please help us by checking employment, health issues, church commitments, childcare and personal engagements before signing up for this important summit. By checking this box you acknowledge how important your registration commitment is to our organization.
 
You will receive a confirmation email to declare your space and to give the location, date, and time information. Filling out this form does not automatically place you in the next retreat. We usually have a waiting list, and ask you to let us know as soon as possible if you will not be able to attend. We are liable for all charges if you commit to coming and do not attend.

*Please note upon your confirmation we begin our plans for you. All supplies are included. There are no fees for the summit. Please note dates and locations are subject to change.

If you have any questions please contact Shirley at hope@realoptions.net or 650-964-8093.
 

Pregnancy | Abortion | Adoption | Post-abortion Healing | Sex & STDs | For Men | About | Locations | Home |


© Copyright 2010 RealOptions
pageAccess Software - Web Site Enhancement, Management and Content Integration Tools.