03-20-21 Virtual Retreat Registration Form - Emmaus Ministry For Grieving Parents

URL

This field is for validation purposes and should be left unchanged.

REGISTRATION INFORMATION

Thank you for registering for this Emmaus Ministry Virtual Retreat offered in cooperation with the Archdiocese of Omaha and St. Patrick's Catholic Church in Elkhorn, NE. We plan to resume physical retreats as soon as we are able. In the meantime, we believe the Holy Spirit--and your child--will bring you peace and comfort, no matter what.

Parent Name-1*

First Last

Registration Selection*

Are you registering as an individual or as a couple?

Parent Name-2

First Last

Please indicate your status.*

This is my first Emmaus Ministry retreat
This is not my first Emmaus Ministry retreat
I am a future retreat team member; I am not a grieving parent.

I have attended other Emmaus Ministry retreats in (where)?

Email*

Phone*

Address*

Street Address City State ZIP Code

TECHNICAL SUPPORT*

If you need technical support for this retreat in finding and logging in to a Zoom meeting, please let us know, as we may be able to provide this before the retreat. Do you need technical support?

Yes
No

RECORDING*

Parts of this retreat that do not include personal interactions, will be recorded, so that we can offer it virtually to other parents via the Emmaus website. Do you understand this?

Yes
No

FREE-WILL OFFERING-OPTIONAL

Your optional donation will be used to help offset our considerable costs of contracting professional technical support, purchasing equipment necessary for virtual retreats, and providing retreat materials. Any donation of any amount is deeply appreciated, but not necessary.

How much would you like to donate?

Total

$0.00

Credit Card

Card Details

Cardholder Name