RETREAT REGISTRATION

• Name and Date of Retreat
• Your Title Fr. Sr. Mr. Mrs. Ms. Br. Dr. Dcn.
• First Name*
• Middle Initial
• Last Name*
• Suffix
• Age
• Street Address*
• City*
• State*
• Zip*
• Phone*
• Home Phone Cell Phone Business Phone
• Email*
• Emergency Contact’s (EC) Full Name*
• Emergency Contact’s (EC) Phone Number*
• EC’s Relationship to the Retreatant*
• Occupation/Ministry
• Religious Affiliation
• Special Needs First floor room Diabetic diet Vegetarian diet
• Preference for Director None Laywoman Sister Priest
• Date of Arrival* (Choose date from June 14 through June 21, 2021)
• Time of Arrival* (If your arrival date is the first day of the Session (i.e. June 14), your arrival time should not be earlier than 5:00 PM.)
• Date of Departure* (Choose date from June 15 through June 23, 2021)
• Time of Departure* (If your departure date is the last day of the Session (i.e. June 23), your departure time should not be later than 10 AM.)
• Do you or have you had a Spiritual Director? If current, how long have you been in direction? If past, how long has it been since you have received spiritual direction?
• Have you made a directed retreat before? Yes No
• Is this your first retreat? Yes No
• If No, where have you made a retreat and when was it?
• Are you confident and comfortable with a totally silent retreat?
• What are you hoping for in this retreat? (e.g., quiet time with God, direction in prayer, making important decisions, etc.)
• Additional Comments:

Registration Fees

You must select at least one item!