10-25-25 Green Bay One-Day Retreat Registration Form

Offered in cooperation with the Diocese of Green Bay, St. Thomas More Parish, and the Emmaus Ministry for Grieving Parents

"*" indicates required fields

Registration Selection*

Please register for this retreat by completing this form. If you have any difficulty completing it, please call Diane at (800) 919-9332 or email her at [email protected].

Please indicate your status.*

This is my first Emmaus Ministry retreat.

This is not my first Emmaus Ministry retreat.

I am a current or future retreat team member; I am not a grieving parent.

I have participated in Emmaus Ministry retreats at (where?)

Name - Primary*

First Last

Email - Primary*

Phone - Primary*

Address - Primary*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent 2 Name (if attending this retreat)

Use this field to enter any additional guest names.

Coupon

Total

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Stripe Total

Credit Card

Card Details

Cardholder Name

Name

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