Retreat Registration

Thank you for your interest in attending our First Responders' Bridge Retreat, which will be held August 11th - 13th, 2023.

Click here to view our retreat agenda for an example of what to expect.

Please note that registration for this retreat is for first-time attendees. If you have attended a previous retreat, we will be having a follow-up retreat that you will receive a private invitation to.

NOTE: When you register for your hotel room, if it says that "all rooms are full for our group", please call the Hotel Rooms Manager directly - Michael McCann, 614-336-4720. Make sure you tell him you are with the "First Responders' Bridge group" so they will add you to our account so you will not have to pay for your lodging. After you receive your confirmation number add it to your registration form below. If you have already completed your registration form, please email your confirmation number to mick@firstrespondersbridge.org Thank you.

August Retreat Registration

Have you previously attended a Bridge retreat? *

Are you registering as the First Responder or their Significant Other? *

First Responder
Significant Other

This is so we know who to contact regarding the the retreat

First Responder

First Responder's Name *

First Responder's Personal Email *

Please use an email address other than your work email address, which will often block our communication with you.

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Age

Gender *

This information is only used for grant applications in aggregate form.

Race *

This information is only used for grant applications in aggregate form.

Ethnicity *

This information is only used for grant applications in aggregate form.

First Responder's Occupation *

Years of Service

Are you currently active or retired?

Active
Retired

Are you a former military service member?

Briefly tell us about the First Responder and/or the Significant Other *

Significant Other

Will a significant other be attending with the First Responder? *

The Retreat

What are your expectations? *

How did you hear about us?

Will you need lodging at the hotel? *

We provide lodging for free. While we do not require you to stay at the hotel during the weekend, it is recommended so that you have the opportunity to socialize with your peers, and to allow yourself to be removed from distractions that prevent you from focusing on your healing.

Food Allergies

Please list any food allergies that we should be aware of.

Emergency Contact

If attending the retreat without a significant other, please provide an emergency contact who will be available during the weekend to be contacted in the unlikely event of an emergency.

Contact Name

Contact Relation

Contact Phone

Contact Alternate Phone

Click here to consent to allow First Responders' Bridge to contact the above individual in case of an emergency, and to disclose medical information if necessary.

I consent

Comment

August Retreat Registration

Please Read

First Responder

Significant Other

The Retreat

Emergency Contact