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Curé of Ars CRHP Registration
Please complete the information below and submit your registration.
You will be contacted in the near future with more details.
For additional information please contact the parish office at 913-649-1337
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Retreat Dates
*
Women's Retreat October 11th & 12th, 2014
Men's Retreat October18th & 19th, 2014
First Name
*
Your answer
Last Name
*
Your answer
Address
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City, State & Zip Code
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Phone #
*
Your answer
Email
*
Your answer
Please check all that apply
Curé of Ars Parishioner
21 years or age
If you have any specific food allergies or dietary needs please describe them.
This will help ensure that we meet your dietary needs on the retreat weekend.
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Do you have any questions or comments?
Your answer
Emergency Contact Information
In case of an emergency who should we contact.
Emergency Contact Full Name
*
Your answer
Relationship
*
Your answer
Phone #
*
Your answer
Email Address
*
Your answer
Is there any additional emergency contact information that you want us to have?
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