12-07-24 Fairfield County Registration Form

Diocese of Bridgeport Catholic Cemeteries in cooperation with the Emmaus Ministry for Grieving Parents

"*" indicates required fields

REGISTRATION INFORMATION

Thank you for registering for this Emmaus Ministry Retreat. 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

COST

All costs connected with this retreat are covered by the Bereavement Initiative of the Catholic Cemeteries of the Diocese of Bridgeport.

Comments

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