2023 &#034;Encounter&#034; High School girls Retreat Registration

RETREATANT INFORMATION

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Age REQUIRED Please fill out this field. Please enter valid data.

Grade Level (for upcoming Fall 2022) REQUIRED Please fill out this field.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Retreatant Photo REQUIRED I have uploaded the photo to the link below I will upload the photo after I submit this form Please fill out this field.

Upload Encounter Retreatant Photo

PARENT/GUARDIAN INFORMATION

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Mailing 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 a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

I would like to make reservations for REQUIRED Session 1: July 5-9, 2023 Session 2: July 11-15, 2023 Please fill out this field.

My child will need transportation to & from the airport. REQUIRED Yes No Please fill out this field.

If YES, please email the itinerary to [email protected]

EMERGENCY INFO & MEDICAL NEEDS

Name of additional contact in case of emergency REQUIRED Please fill out this field. Please enter valid data.

Relationship to retreatant REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Health Concerns (e.g. allergies, special needs, dietary requests, etc.) REQUIRED Please fill out this field. Please enter valid data.

LIABILITY WAIVER & MEDIA RELEASE FORM

The form can be found on the left of this registration form. Please carefully read, fill out, and upload the waiver form to Encounter Retreatant Waiver Form.

Waiver Form REQUIRED I have uploaded the waiver form to the link above I will upload the waiver form after I submit this form Please fill out this field.

RETREAT DONATION

To assist with expenses pertaining to the retreat, a humble donation is requested. The suggested amount is $125, which includes the pre-registration deposit, lodging, meals, & sessions/activities.

If you are donating by check: Please make out your check to "Dominican Sisters" and include the attendee's name on the memo line or in a note with the check. Mail your check to: Vocation Office, 5250 Gasmer Dr., Houston, TX 77035

If you are paying by credit card: Please submit payment below.

Thank you kindly for your generosity!

Donation Amount REQUIRED $ Please fill out this field. Please enter a positive decimal.

Offset Service Fee REQUIRED Please add 3% to help offset processing fees. Not this time, thank you. Please fill out this field.

Comments/Questions:

Please note: Registration is not fully completed until the retreatant photo and the liability waiver/media release form has been submitted. Your reservation will be confirmed upon submission of all necessary documents. Thank you!

Dominican Sisters
of Mary Immaculate Province

Tỉnh Dòng ĐỨC MARIA VÔ NHIỄM

2023 "Encounter" High School girls Retreat Registration

Retreat Documents / links