REGISTRATION INFORMATION

Thank you for registering for this Emmaus Ministry Retreat, our first In-Person Retreat in 2021! Welcome! If this is your first Emmaus Ministry Retreat, a member of our team will be calling you soon to give you more information and answer any of your questions.

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

FREE-WILL OFFERING-OPTIONAL

Your optional donation will be used to help offset our costs of providing three meals and all 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

Phone

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

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08-14-21 Emmaus Ministry In-Person Retreat Registration

REGISTRATION INFORMATION

FREE-WILL OFFERING-OPTIONAL