06-19-21 VIRTUAL RETREAT REGISTRATION FORM - Emmaus Ministry For Grieving Parents

06-19-21 Emmaus Ministry Virtual Retreat Registration

REGISTRATION INFORMATION
Thank you for registering for this Emmaus Ministry Virtual Retreat. You will receive a link and password the week before the retreat via email.
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
EMMAUS WALK*
During the retreat, you will have the opportunity to meet virtually with another grieving parent one-on-one in an "Emmaus Walk" to talk about your spiritual journey after the death of your child. Would you like to take this optional, virtual Emmaus Walk?
- 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
Comments
This field is for validation purposes and should be left unchanged.

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06-19-21 Emmaus Ministry Virtual Retreat Registration

REGISTRATION INFORMATION

FREE-WILL OFFERING-OPTIONAL