Adult Retreat Registration and Payment

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Adult Registration

Register for either a Men's Retreat or Women's Retreat
Make Final Payment

Print Paper Form*
- *PLEASE NOTE: Online registration is faster and easier, for both the retreatant and our volunteers;
  however, you may use the mail-in paper form by clicking the "Print Paper Form" button.
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Select Adult Retreat
  
  Which Retreat are you registering for? REQUIRED Please fill out this field.
  
  Are you Registering as a Retreatant or Team Member? REQUIRED Retreatant ACTS Team Member Please fill out this field.
  
  Registration Form (Part A)
  
  Payment Verification REQUIRED I will pay the $100.00 deposit which leaves a balance of $100.00 owed I will pay the $200.00 fee in full Please fill out this field.
  
  Participant's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Participant's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Sex REQUIRED Male Female Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  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 valid data.
  
  Home Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Cell Phone Number Please enter valid data.
  
  Registration Form (Part B)
  
  Who Introduced You to ACTS? Please enter valid data.
  
  Phone Number Please enter valid data.
  
  Are you married?
  
  Has your spouse attended an ACTS Retreat?
  
  Are they scheduled to attend?
  
  Are you a practicing Catholic?
  
  If so, which Parish/Church? Please enter valid data.
  
  Do you practice another faith?
  
  Church/City Please enter valid data.
  
  Dietary and Medical Needs
  
  Will you have any specific dietary or medical needs during this weekend?
  
  My needs are
  
  I am allergic to Please enter valid data.
  
  Emergency Contact Information
  
  Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship Please enter valid data.
  
  Emergency Contact Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Final Payment: A deposit of $100 will guarantee your spot for the retreat. Full payment must be received on or before the date of the retreat. If you are only paying your deposit today, please visit our final payment page to make your final payment.
  
  Payment Type REQUIRED 100.0 – Deposit 200.0 – Full Payment Please fill out this field.
  
  Payment Amount REQUIRED Please fill out this field.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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*PLEASE NOTE: Online registration is faster and easier, for both the retreatant and our volunteers;however, you may use the mail-in paper form by clicking the "Print Paper Form" button.

PLEASE NOTE: Online registration is faster and easier, for both the retreatant and our volunteers;
however, you may use the mail-in paper form by clicking the "Print Paper Form" button.*