Download & Print 2024 Registration Form
Download & Print Fall 2024 Registration Form
Please make your food selections and mail to: Gwendolyn Surratt 4753 Smoketalk Lane Westerville, OH 43081
If you chose to mail your regestration, please total your meal prices, add the 60.00 for the retreat. Mail a check for the total to: Natalie Mouw 2405 Miller Paul Road, Galina OH 43201 Printable Registration Form AQN Fall 2024 Retreat
“*” indicates required fields Name *
First Last
City State zip
Phone* Email*
Meal Choices
Five thoughtful meals have been planned, that accommodate a variety of food desires, plus snacks for $106.00 for the entire retreat. All meals will be served buffet style. Make your choices by selecting one preference for each meal section. Please know there are NO SPECIFIC OPTIONS unless you have food allergies. Please state your food allergies below on this form.
Questions or concerns regarding meals, call Gwen Surratt: 614-439-2344.
Thursday Dinner: Catered by Sweet Carrot* $25 Corn cakes, coleslaw, charred carrots, roasted veggies. Carrot cake.
Veggie Sliders
Pulled Pork Sliders
I will not be attending.
Friday Lunch: Agape Mediterranean* $20 Rice bowl, sides & Baklava.
Beef Chicken Falafel Veggie
I will not be attending.
Friday Dinner: Piada Italian Street Food* $22
Piada wraps and Kettle chips. Pie – Just Pies.
Chicken Pesto
Steak and Avocado Mediterranean
Veggie
I will not be attending.
Saturday Lunch: Smiths Deli* $15 Croissant rolls sandwiches with chips. Cookie.
Turkey
Roast Beef
Vegetarian
I will not be attending.
Saturday Dinner: Dewey’s Pizza* $18 Salad
Chicken
Sausage/Pepperoni
Vegetarian
No Cheese
I will not be attending.
Drink Survey:*
Still Water
Sparkling Water