Apply for the House of Life

Application Form

Please fill out the form below and press the “Confirm” button. If required fields (marked with *) are not filled, error messages will appear in red. Please complete the form and press the “Confirm” button.

Name
Address
Cell Phone
Home Phone
Contact	Cell Phone Home Phone Either is fine.
Email
Confirm Email
Usage Period	Arrival Date year month day Departure Date year month day
Arrival Time	If you are late for registration at the Church of the Wind, please let us know your arrival time.
Gender	Female Male
Age
Emergency Contact	Name Relationship Phone
Notes
Is this your first time using the House of Life?	Yes No

Companion

The same application form can be used only for an infant or a person who needs care.
Do you have a companion?

Companion 1

Name
Gender	Female Male
Age
Relationship

Companion 2

Name
Gender	Female Male
Age
Relationship

Agreement

I have read "Before Applying" and "Notice."
I understand that the House of Life is for the purpose of being still before the Lord.
I (and my companions) hereby agree to use the House of Life for this purpose and not to disturb others’ prayer.

Agree