Registration Application – While We’re Waiting Weekend in Hot Springs, Arkansas Name*Spouse's Name (Only required if your spouse will be attending with you)PLEASE NOTE: Our 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 regard.The Name(s) of your Child(ren) Who Died:*Your Email Address* Enter Email Confirm Email Your Phone Number*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Your Home Church*Please choose the retreat you'd like to attend.* June 5-7, 2020 - This event is full, but you may choose this option to be added to our waiting list. June 19-21, 2020 - This event is full, but you may choose this option to be added to our waiting list. September 4-6, 2020 - This event is full, but you may choose this option to be added to our waiting list. September 25-27, 2020 - This event is full, but you may choose this option to be added to our waiting list. November 13-15, 2020 - This event is full, but you may choose this option to be added to our waiting list. December 4-6, 2020 January 22-24, 2021 February 5-7, 2021 April 9-11, 2021 June 4-6, 2021 July 16-18, 2021 September 24-26, 2021 November 12-14, 2021 December 3-5, 2021 You may choose multiple events if you'd like to be added to multiple waiting lists. 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?*If you have any food allergies, please list those here. If not, you may leave this section blank.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 and damages, even if caused by negligence of While We're Waiting. I further hold harmless While We're Waiting from any claims, damages, injuries, or losses caused by my own negligence while a guest at The Refuge or any other 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 to the Release of Liability above.