2016 Gay Men’s Autumn Health Retreat Registration

 October 21-23, 2016
(Confidentiality Ensured)

You MUST be 18 years or older to register for this retreat.

Please complete the following electronic registration form as thoroughly as possible. Make sure you hit the “Submit My Registration” button at the bottom of the electronic registration form. DO NOT HIT ENTER. INSTEAD TAB OR CLICK THROUGH THE FIELDS (Hitting enter will submit your registration form prematurely). You will be contacted shortly (within 2 – 3 business days) to confirm your registration. Registration deadline is October 14th, 2016.

If you have any questions regarding this registration or about our Gay Men’s Autumn Health Retreat, please call 406-829-8075 or email: fdh@mtgayhealth.org.

Register for 2016 Gay Men's Autumn Health Retreat
  1. (required)
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  5. Do you live in Montana?
  6. (valid email required)
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  8. Have you been to a FDH or GMTF sponsored retreat in the last 12 months?
  9. Do you have any medical or dietary restrictions?
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  13. The retreat ends on Sunday at approx. 12:00pm
  14. I, the undersigned, understand and agree to release the Montana Gay Men's Task Force, FDH & Associates, their members and officers, designated assistants, other attendees, and affiliated groups and persons, from any and all liability including all degrees of physical and/or mental injury, property damage, loss, or theft that may be incurred as a result of my attending the Gay Men's Autumn Health Retreat. I understand and accept that attendance is purely at my own risk. I agree to the strict no drug or alcohol rule and realize that I may be asked to leave if I violate this policy. I have filled out this form fully and completely to the best of my knowledge.
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