2021 PreCana Day of Reflection Registration if paying with credit card

Bride's Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Bride's Phone*

Bride's Email

Religion*

Groom's Name*

First Last

Groom's Address*

Street Address City State ZIP Code

Groom's Phone*

Groom's Email

Religion*

Priest Assisting Your Marriage*

Parish*

Parish Town or City*

Wedding Date*

Address after Marriage*

Street Address City State ZIP Code

For scheduling purposes, all registrations must list two different date choices. If two different dates are not chosen on this form, we will contact you to obtain that information. •

Conference Date First Choice*

Conference Date Second Choice*

Pre-Cana Conference Fee

Price: $100.00

Once you are married the diocese would like to continue supporting your marriage by sending you a monthly newsletter for newlyweds.