Sprague's Kinderhook Lodge in Barry, Illinois

Our Illinois retreats are held at Sprague’s Kinderhook Lodge in Barry. Kinderhook Lodge is a bed and breakfast, hunting lodge, special events and retreat center located in picturesque Pike County. The lodge is located on the Pikes Peak Ocean to Ocean Highway and is rich in history.

While We're Waiting Weekend Registration Form - Kinderhook Lodge in Barry, Illinois

UPCOMING DATES
Please choose the date you'd like to attend.*
- March 3-5, 2023
- Please contact me when future retreats are scheduled at this location.
REGISTRATION DETAILS
First and Last Name*
Spouse's Name (Only required if your spouse will be attending with you)

PLEASE NOTE: The board-approved policy states that couples who are not in a Biblically-based marriage may not share a guest room. These couples are welcome to attend; however, separate guest rooms will be assigned, if available. Thank you for your understanding in this matter.
The Name(s) of your Child(ren) Who Died:*
Your Email Address*
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Your Phone Number*
Confirm Phone Number*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Home Church*
Please tell us about your family ... including the child(ren) who died and the circumstances of the death. Include as much or as little detail as you wish.*
What are you most hoping to gain by attending this retreat?*
Do you have any accessibility or health issues of which we need to be aware? If so, please explain. If not, you may leave this section blank.
How did you hear about While We're Waiting?*
RELEASE OF LIABILITY: By checking here, I agree to waive, discharge claims, and release from liability the While We're Waiting ministry from any and all liability on account of, or in any way resulting from injuries, damages, or illness (including COVID-19) even if caused by negligence of While We're Waiting. I further hold harmless While We're Waiting from any claims, damages, injuries, illnesses, or losses caused by my own negligence while a guest at this retreat site. I understand and intend that this assumption of risk and release is binding upon my heirs, executors, administrators and assigns, and includes any minors and/or guests accompanying me in activities associated with While We're Waiting events.*
- I have read and agree with the Release of Liability statement above.
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Sprague’s Kinderhook Lodge in Barry, Illinois

While We're Waiting Weekend Registration Form - Kinderhook Lodge in Barry, Illinois

UPCOMING DATES

REGISTRATION DETAILS