Online Adult Form

Please note: Although we prefer online registration, if you need a mail in form, you can get one here.

Please complete the following form to finish your registration
for the
Adult ACTS Retreat

(All Information will be kept confidential)

For adult retreat or registration information contact April Fetterman @ 806 -681-0804
or email: aprilf0824@sbcglobal.net

The maximum number of form submissions has been reached. This form is currently not available.

Select Retreat
- Which Retreat REQUIRED
  Which ACTS Retreat are you registering for? Deadline to Register is the Thursday before the Retreat
  Please fill out this field.
- Registering as a Retreatant or Team Member? REQUIRED Retreatant ACTS Team Member Please fill out this field.
Personal Information
- Payment Verification REQUIRED I have paid a $100.00 Deposit which leaves a balance of $75.00 I have paid $175.00 in Full I have paid $100.00 and I have received a scholarship Please fill out this field.
- Email Used on Paypal REQUIRED Please fill out this field. Please enter valid data.
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Name you wish to be called by. REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
- State REQUIRED Please fill out this field.
- Zip REQUIRED Please fill out this field. Please enter an integer (number).
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Main Contact Phone REQUIRED Please fill out this field. Please enter valid data.
- Alt Phone Please enter valid data.
- E-Mail Address REQUIRED Please fill out this field. Please enter an email address.
Contact Information
- Family Emergency Contact Person REQUIRED Please fill out this field. Please enter valid data.
- Relationship to Contact Person REQUIRED Please fill out this field. Please enter valid data.
- Phone Number of Contact Person REQUIRED Please fill out this field. Please enter valid data.
Miscellaneous
- ACTS Sponsor or Who introduced you to ACTS? Please enter valid data.
- What is his or her phone number? Please enter valid data.
- Are you a practicing Catholic? REQUIRED Yes No Please fill out this field.
- If Yes what Parish and City Please enter valid data.
- Protestant Yes
- May we publish your name on a prayer list for this retreat? REQUIRED Yes No Please fill out this field.
- Will you have any specific dietary or medical needs during this weekend? If Yes please enter needs here.
Final Check. Please check your registration form and Submit.
- I hereby confirm the information on this Registration Form is correct. REQUIRED Please fill out this field. Please enter valid data.

Submit

Thanks and God Bless!

A.C.T.S. - Diocese of Amarillo

Adoration - Community - Theology - Service

Online Adult Form

Please note: Although we prefer online registration, if you need a mail in form, you can get one here.

Please complete the following form to finish your registration
for the
Adult ACTS Retreat

Online Adult Form

Please note: Although we prefer online registration, if you need a mail in form, you can get one here.

Please complete the following form to finish your registration for the Adult ACTS Retreat

Please complete the following form to finish your registration
for the
Adult ACTS Retreat