Spur Nights Couple's Study

Event: Spur Nights Couple’s Study
Date: February 4, 11, & 18, 2020
Time: 6:30 – 8:00 PM
Location: Barren Heights Community Center
Address: 11420 Watterson Court, Suite #800, Louisville, KY 40207

What a better way to start the year than by spurring one another to love and good works! Join our Couple’s Ministry, led by Joe and Toni Rose along with John and Lorie Weires, as they share personal stories of marriage failure, success, adventure, and what God has taught them throughout. This event hosts only 6 couples so submit your RSVP today!

*By submitting an RSVP form, you are agreeing to attend ALL 3 SESSIONS of the Spur Nights study*

Couple's Event Form

Father/Husband's Name
First Last
Dad's T-Shirt Size
Dad's Email
Dad's Phone
Dad's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Mother/Wife's Name
First Last
Mom's T-Shirt Size
Mom's Email
Mom's Phone
Mom's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Do you have a child with physical or developmental disabilities?*
- Yes
- No
Will you be utilizing our free childcare for this event?*
- Yes
- No
# of Children Attending
Child 1
Child 1
First Last
Child 1: Gender
Child 1: T-Shirt Size
Child 1: Disability
Child 1: Specific Diagnosis
Child 1's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 2
Child 2
First Last
Child 2: Gender
Child 2: T-Shirt Size
Child 2: Disability
Child 2: Specific Diagnosis
Child 2's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 3
Child 3
First Last
Child 3: Gender
Child 3: T-Shirt Size
Child 3: Disability
Child 3: Specific Diagnosis
Child 3's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 4
Child 4
First Last
Child 4: Gender
Child 4: T-Shirt Size
Child 4: Disability
Child 4: Specific Diagnosis
Child 4's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 5
Child 5
First Last
Child 5: Gender
Child 5: T-Shirt Size
Child 5: Disability
Child 5: Specific Diagnosis
Child 5's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 6
Child 6
First Last
Child 6: Gender
Child 6: T-Shirt Size
Child 6: Disability
Child 6: Specific Diagnosis
Child 6's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 7
Child 7
First Last
Child 7: Gender
Child 7: T-Shirt Size
Child 7: Disability
Child 7: Specific Diagnosis
Child 7's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 8
Child 8
First Last
Child 8: Gender
Child 8: T-Shirt Size
Child 8: Disability
Child 8: Specific Diagnosis
Child 8's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 9
Child 9
First Last
Child 9: Gender
Child 9: T-Shirt Size
Child 9: Disability
Child 9: Specific Diagnosis
Child 9's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
Child 10
Child 10
First Last
Child 10: Gender
Child 10: T-Shirt Size
Child 10: Disability
Child 10: Specific Diagnosis
Child 10's Food Restrictions, if any
(Allergies, Special Requirements, etc.)
All application information is kept confidential. Application information may be shared with retreat volunteers so they are better equipped to serve your family. This information will not be distributed or used for marketing purposes.

Hold Harmless Agreement

By checking the boxes below you are agreeing on behalf of your family to an electronic signature.
Please check if you agree with the following statements:*
- I give my consent that the information given at registration may be communicated with leaders and volunteers for the purpose of being equipped to provide the best care and assistance possible to my family.
- I give my consent that photographs, interviews and audio/visual recordings during the course of the event may be used by Barren Heights for training, promotion, and fundraising.
- I release Barren Heights, its directors, and volunteers, and the Community Center facility from all actions, damages, or personal injuries which may occur to me or a member of my family. I understand that in the event of a minor injury, I, or a member of my family may receive first aid treatment. I will be informed as soon as possible of any injury or condition of one of my family members and will be responsible thereafter for their care. In the event of an emergency, injury, or illness, emergency medical services and I will decide the best course of action. If the leaders are unable to reach me, I authorize them to take whatever action is necessary for the safety and health of my family members.
- I understand that in order for everyone to experience a sense of calm, peaceful relaxation, the Community Center is an alcohol, drug, and smoke-free environment. Use of cell phones is discouraged except when necessary.
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

Super Bowl Viewing Party

February 2 6:00 pm

Barren Heights Community Center

Couple's Event Form

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Child 7

Child 8

Child 9

Child 10

Hold Harmless Agreement

Super Bowl Viewing Party

February 2 6:00 pm

Barren Heights Community Center

February 4 6:30 pm

Barren Heights Community Center

Cultivating Love & Respect Marriage Retreat

February 15 9:00 am

Barren Heights Community Center

Women's Paint Spot Party

March 3 6:30 pm

Barren Heights Retreat Center

Stay up to Date!