MEC Walk Application Information

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This information will not be shared outside of the Walk to Emmaus and the Upper Room Programs.
After completing your application you can send a check for a $30 deposit and mail it to:
Michiana Emmaus Community PO Box 1026 Elkhart, IN 46515-1026. The total cost of retreat is $130 for 3 days.

Preferred First Name: (Will appear on Name Badge) *

Last Name *

Select a Walk to Attend: *

Men's Walk to Emmaus on October 6 - 9, 2022

Women's Walk to Emmaus on October 13 - 16, 2022

Date of Birth: *

YYYY

Gender: *

Male

Female

Street Address *

City *

State *

Zip Code *

E-Mail Address *

Home Phone / Cell Phone *

Church Name / Denomination *

Emergency Contact (First & Last Name): *

Emergency Contact Phone Number: *

Has your sponsor explained the Emmaus Walk to you? *

Yes

State why you would like to attend:

If you are married, has your spouse been on a Walk to Emmaus or will be attending a walk? *

Yes

Could you partake in open communion? *

Yes

Are you willing to dedicate a complete 72 hours while attending this walk? *

Yes

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