Divine Mercy Retreat Registration
Join us 4/15/2023 at 1 pm for a Young Adult Retreat!
Name
*
First Name
Last Name
Email
*
example@example.com
Home Parish
*
Parish Name
Town
I want to register my spouse.
*
Yes
No
Name
*
First Name
Last Name
Email
*
example@example.com
Home Parish
*
Parish Name
Town
Childcare will be available from 1-5pm. I will need childcare.
*
Yes
No
Age and Name of children in need of childcare:
I am registering for:
*
Saturday afternoon only (1- 5pm Mass)
Saturday afternoon, Mass, and Dinner(1 - 7:30 pm)
Total number attending dinner:
*
How did you hear about the Divine Mercy Retreat?
*
Personal Invitation
Radio/newpaper/bulletin
Announcement at Mass
Social Media Advertisement
Chancery Chatter Newsletter
Awesome! Who invited you?!
*
(First and last)
Payment
*
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Individual Registration
$20.00
$
20.00
Married Couple Registration
$40.00
$
40.00
My Parish Is Awesome and Has Agreed To Pay My Registration Fee!
Free
$
Free
Save
Register
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