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Women's ACTS

- Ministries & Organizations

Women's ACTS Retreat
July 28-31, 2022
The maximum number of form submissions has been reached. This form is currently not available.
- Personal Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred Name for Name Tag Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish/Church REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Medical/ Allergy/ Dietary Needs
- Have you been on an ACTS Retreat before? REQUIRED No Yes Please fill out this field.
- The cost of the retreat is $200. This completed registration form along with a $50.00 non-refundable deposit is due at the time of registration and will reserve your place on the retreat. The remaining balance is due on or before July 28th with checks made payable to St. Matthew ACTS.
- Amount Paid $50 Deposit Full $200
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