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Rosa Mystica Registration Form
Register for Retreats at the Our Lady of Rosa Mystica House of Prayer right here!
Please note - this form does not take payments. You'll receive an e-mail or phone call regarding payment.
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Email
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Your email
First Name
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Your answer
Last Name
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Your answer
Cell Phone Number
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Your answer
Street Address
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Your answer
City
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Your answer
State
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Your answer
Zip Code
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Your answer
I'd like to register for the following day(s)/weekend(s)
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Please select ALL that apply
8/24 - 8/26 A Weekend with Mama with Deacon Jacques
9/20 - 9/22 Padre Pio Weekend
12/6-12/8 Immaculate Conception Weekend
Other:
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Number of people in your party
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Names of others in your party
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Anything else we should know?
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A copy of your responses will be emailed to the address you provided.
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