Catholic Women’s Retreat Registration if paying with credit card

Catholic Women's Retreat Registration if paying with credit card

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Age Range (please select one)(Required)

18-20

21-35

36-55

55+

Email(Required)

Phone(Required)

Parish (Please select your parish from drop down menu below.)(Required)

Dietary Restrictions (Please let us know if you have any food allergies or dietary restrictions that you might need.)

Lodging (Please let us know if there is someone you would like to room with or if you would prefer to have a single room.)

Retreat Cost - This cost includes lodging for two nights, 4 meals (Saturday and Sunday), and support for speaker fees.

Adult Fee (over the age of 23) $125 Shared Room

Price: $125.00

Adult Fee (over the age of 23) $175 Single Room

Price: $175.00

Student Fee (between 18-23) $75 Shared Room

Price: $75.00

Student Fee (between 18-23) $100 Single Room

Price: $100.00

Good Samaritan Registration ( I would like to donate a registraiton fee for a woman who cannot afford to attend but would like to participate in this weekend retreat.) $145

Price: $145.00

Total

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