Men's Winter 2023 Registration

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Thank you for your interest in the Men's winter 2023 ACTS Retreat
Thursday, February 23 (evening) through Sunday, February 26 (early afternoon).

Please fill out this registration form and our team will contact you after. If you have questions, you may e-mail us at actssfa@gmail.com

Name *

Preferred Name for Nametag: *

Physical Address *

City *

State *

Zip Code *

E-mail Address *

Primary Phone Number *

Secondary Phone Number (if available)

Home Parish *

If other, please specify:

T-shirt Size *

XXL

3XL

4XL

Any allergies or dietary concerns? *

Do you have any mobility concerns or problems navigating stairs? (Elevators are available) *

Yes

First Emergency Contact's Name *

First Emergency Contact's Relationship to You *

First Emergency Contact's Phone Number *

First Emergency Contact's E-mail Address *

Second Emergency Contact's Name

Second Emergency Contact's Relationship to You

Second Emergency Contact's Phone Number

Second Emergency Contact's E-mail Address

This serves form serves as your registration, but your place will not fully reserved until payment is received. The full cost is $200. Cost may be split into two payments with the first $100 due to reserve your place and the second due before the first retreat. How would you prefer to pay? *

Cash or Check (We will arrange payment with you)

Online (A link will be provided after you submit your registration)

Submit

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