Private Retreat Reservation Form

Address: *

Day Phone Number: *

Area Code Phone Number
Evening Phone Number:

Area Code Phone Number
Email:
example@example.com
Parish or Church:
Arrival Date: *

Month Day Year
Date
Arrival Time: *

: Hour Minutes AM/PM Option
Departure Date: *

Month Day Year
Date
Departure Time: *

: Hour Minutes AM/PM Option
For health reasons only, I prefer a room:
Do you have any Extreme Food Allergies; Health Issues (e.g. Diabetes, Celiac) - Not Food Preferences? If so, please explain:
We require a $50.00 non-refundable deposit at the time of registration. Your deposit is applied to the final balance of your payment.

If paying by check please mail your payment to:

Sacred Heart Retreat House
Reservations Coordinator
P.O. Box 185
Sedalia, CO 80135

When paying by check please print out a copy of your reservation receipt and include it with your check. This will guarantee that your deposit is properly credited to you.

(Please note that if you pay by check your registration will not be complete until we receive your payment.)

If you would like to pay by credit card now, please use the form below.

To pay by credit card please choose the option below:

Private Retreat Non-Refundable Deposit $ 50.00

Total $ 0.00