Antioch Sign Up!
Complete this form to sign up for the spring Antioch Retreat held from Saturday, February 23 - Sunday, February 24. Be sure to follow the online giving link to pay the retreat fee.
Allergies or Special Dietary Needs:
Are you in need of a scholarship to attend this retreat?
Emergency Contact First Name:
Emergency Contact Last Name:
Emergency Contact Relationship:
Emergency Contact Phone Number:
Emergency Contact Email:
Are you 21 or older?
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This form was created inside of Archdiocese of Dubuque.
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