Request edit access
Catholic Women Nurses Retreat at Bethany Retreat House, November 2-4, 2018
Registration is on a first-come, first-served basis. Cancellations less than 30 days before the event are non-refundable. Please indicate on the "For" line of your check: "CWNR 11/18." In the form below is a section where you must insert your CHECK NUMBER. Please make checks payable to BETHANY RETREAT HOUSE in the amount of $225.
Email address *
Last Name *
Your answer
First Name and Middle Initial *
Your answer
Street Address, including City, State, and Zip Code *
Your answer
Home Phone Number *
Your answer
Mobile Phone Number *
Your answer
Dietary and/or Physical Restrictions (if applicable):
Your answer
Emergency Contact (Name, Relationship, Phone) *
Your answer
Check Number (Total amount: $225 to "Bethany Retreat House") *
Your answer
Date of Check (mm/dd/yy) *
Your answer
I agree to the Terms and Conditions of Bethany Retreat House as stated below.
To submit this form, please scroll to the bottom of Terms & Conditions and click the "Submit" button.
Terms & Conditions of Bethany Retreat House
1. Bethany Retreat House is owned and operated by the Dominican Sisters of Saint Cecilia Congregation. Retreats and other events at Bethany Retreat House are selected insofar as the persons or groups requesting are not holding, advancing and advocating beliefs or practices that conflict with the mission of the Congregation or with the magisterial teaching of the Catholic Church, which are summarized in, among other places, the Catechism of the Catholic Church. All activities with the Retreat House are subject to approval by the Director.
2. Retreatants must be 18 years of age or older.
3. Confirmation of the number of participants and any special dietary/physical needs should be forwarded to the Retreat House Director (, ten (10) days prior to the start of the event. Space has been reserved for the Group Representative based on the number of guests indicated in this Agreement. Group Representative will be responsible for payment for the guests at the rate quoted in the Facility Use Agreement. Bethany Retreat House reserves the right to host another event at the same time.
4. Cancellation policy: Cancellation of this agreement may be effected by either party with written notice to the other party. In the event of cancellation by Bethany Retreat House, the deposit and any other retreat fees will be refunded to the Group Representative without further liability on the part of Bethany Retreat House.
5. A nonrefundable deposit reserves the use of Bethany Retreat House. Final payment of all retreat fees is due on or before the date of the retreat. The Group Representative is responsible for paying a stipend to priests and/or other speakers.

1. Smoking and alcoholic beverages are not permitted in Bethany Retreat House or on the grounds.
2. Bethany Retreat House is located on 72 acres and is a beautiful, clean, and serene place in which to encounter God. The staff of the Retreat House asks for your partnership in maintaining this restful environment, both for yourself and for others who are on retreat.
a. Please respect the privacy of the convent, which is the house located next to Garners Creek Road.
b. There are benches for guests to enjoy sitting near the pond, but we ask you please to stay off the dock and out of the water.
c. Plan for casual attire. You will have some break time to enjoy hiking and sitting on the retreat house porches and will probably want to bring comfortable clothing and walking shoes. Trails are available for hiking and for praying the Stations of the Cross. You will need to bring your own insect repellant for walking outdoors and when walking stay on the trails and please know that you assume any risk for tick, chigger, or snake bites, or other potentially harmful wildlife.
3. Visitors are asked to leave the furniture as it is placed. Please discuss with the Director any requests to rearrange furniture.
4. In order to provide an opportunity for prayer, the first floor bedrooms and bathrooms are places of silence. There may be other times/places of silence posted.
5. We encourage retreatants to "fast" from technology during their time of retreat in order to enter deeply into the opportunity for prayer, rest, and reflection. Phones should be set on mute or turned off during the time of retreat. Cell phone reception is limited, so retreatants can provide their families with the Bethany Retreat House number in case of any emergencies:615-446-2063. If it is necessary to take a phone call, guests are asked to go outside or use the phone booth on the first floor.
6. Meals are generally served at 7:30-8:00 a.m., 12 noon, and 6 pm. In order to keep the Retreat House beautiful and pest-free, we ask guests not to eat or store food in the first floor bedrooms.
7. The group representative requests permission to use the Bethany Retreat House for a retreat on the date listed. Bethany Retreat House is not responsible for any lost items or injuries incurred during the group’s use of the Retreat House. The person responsible for the group should exercise adequate oversight to ensure the safety of all retreatants at its function. Visitors at Bethany Retreat House acknowledge responsibility for any damages that may occur during their visit.

A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service