One moment please...
Overnight Semi-silent Retreat Registration
February 7 - 8, 2025
Couples Retreat
Retreat Leaders - Leah and John Sealy
Spouse #1
Spouse #1
*
Prefix
First Name
Last Name
Suffix
How would you like your name to appear on your name tag and other materials?
*
Email
*
Verify Email
*
Cell Phone
*
I would like a text reminder about this retreat.
*
select one
Yes
No
Landline (optional)
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
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.
*
Spouse #2
Spouse #2
*
Prefix
First Name
Last Name
Suffix
How would you like your name to appear on your name tag and other materials?
*
Spouse #2
Email
*
Spouse #2
Verify Email
*
Cell Phone
*
Spouse #2
I would like a text reminder about this retreat.
*
Spouse #2
select one
Yes
No
Landline (optional)
Spouse #2
Birth Date
*
To assist with room assignments, please enter your birthdate. (mm/dd/yyyy) - Spouse #2
Gender
*
To assist with room assignments, please enter your gender. Spouse #2
select one
Male
Female
Prefer not to answer
Do you have any dietary restrictions?
*
You are welcome to bring your own food. A refrigerator and microwave are available for your use. (Spouse #2)
None
Vegan
Vegetarian
Gluten free
Dairy free
Other
Other - Please enter information regarding any other food allergies. (Spouse #2)
*
Additional Details
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Retreat Contributions
*
Quantity
$200
-
Non-refundable Deposit per Retreatant is $100
0
1
1
$480
-
Suggested Contribution per Retreatant is $240
0
1
1
I want to make an additional donation:
$
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
Are you part of a parish/church?
*
select one
Yes
No
Don't know
Enter parish/church name
*
Are you part of a retreat group?
*
select one
Yes
No
Don't know
Enter group name
Do you have a room request based on medical needs?
*
Yes
No
Please enter brief reason for room request, e.g. CPAP machine, limited mobility, etc.
*
Bathrooms are assigned based on age or medical needs. Only 20% of our rooms have ensuite bathrooms.
Have either of you attended a Bellarmine weekend retreat in the past three years?
*
Yes
No
Payment Information