Online Adult Form

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.

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

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