Faiths Lodge Application
Be sure to email us at halosofthestcroixvalley@gmail.com to let us know that you have completed the application.
Please share the name of your child who has died
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Cause of Death *
Your answer
Date of Death *
MM
/
DD
/
YYYY
Age at Time of Death *
Your answer
PARENTS STAYING AT FAITH'S LODGE
Parent 1 First and Last Name *
Your answer
Parent 2 First and Last Name *
Your answer
FULL Home Address *
Your answer
Cell Phone *
Your answer
Home Phone (if applicable)
Your answer
Email Address *
Your answer
SIBLINGS STAYING AT FAITH'S LODGE (if choosing a family weekend rather than a parents weekend)
Full Name and Age of Each Child Staying at Faith's Lodge With You OR enter N/A *
Your answer
Emergency Contact (Name, Phone and Full Address) *
Your answer
Have you stayed at Faith's Lodge before? *
CANCELLATION POLICY: By checking the box below you agree to cover fees ($200) for any cancellation made within two weeks of your arrival date. *
Required
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