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Veterans' Coming Home Retreat Registration
Sunday, October 13, 2024
Veterans' "Coming Home"
Co-Ed Retreat
Retreat Leader - A Jesuit Priest and a Team of Veterans
Name
*
Prefix
First Name
Last Name
Suffix
How would you like your name to appear on your name tag and materials?
*
Email
*
Verify Email
*
Cell Phone
*
Landline (optional)
I would like a text reminder about this retreat.
*
select one
Yes
No
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Birth Date
*
To assist with room assignments, please enter your birthdate. (mm/dd/yyyy)
Gender
*
To assist with room assignments, please enter your gender.
select one
Male
Female
Prefer not to answer
Number of Retreatants
*
Register yourself and up to three other adult family members. Thanks to a generous donor, there is no charge for this retreat.
select one
1
2
3
4
I would like to make a donation:
$
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
Branch of Service
*
select one
Air Force
Army
Marine Corps
Navy
Coast Guard
Space Force
Army National Guard
Air National Guard
Years of Service
*
What is your religious affiliation?
Do you have any dietary restrictions?
*
You are welcome to bring your own food. A refrigerator and microwave are available for your use.
None
Vegan
Vegetarian
Gluten free
Dairy free
Other
Other - Please enter information regarding any other food allergies.
*
Retreat Registrant 2 Details
Registrant 2 Name
*
First Name
Last Name
Registrant 2 Email
*
Please enter the email address of this guest. Please do not re-enter your email address.
Verify Email
*
Registrant 2 Phone (Cell preferred)
*
Retreat Registrant 3 Details
Registrant 3 Name
*
First Name
Last Name
Registrant 3 Email
*
Please enter the email address of this guest. Please do not re-enter your email address.
Verify Email
*
Registrant 3 Phone (Cell preferred)
*
Retreat Registrant 4 Details
Registrant 4 Name
*
First Name
Last Name
Registrant 4 Email
*
Please enter the email address of this guest. Please do not re-enter your email address.
Verify Email
*
Registrant 4 Phone (Cell preferred)
*
Payment Information
If making a donation, the payment screen will appear after clicking "Submit Registration" below.