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Registration:
Men's Cornerstone XXV

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  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Home Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
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  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parish (if affiliated with one): Please enter valid data.
  
  Emergency Contact: Close Family Member or Close Friend (Required)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address (if different from yours) Please enter valid data.
  
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  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  **Additional Family Member or Close Friend - **MUST** BE DIFFERENT than Emergency Contact (Required)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Home Street 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.
  
  Preferred Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Any special needs? Please enter valid data.
  
  Please check to ensure ALL required fields have been entered, otherwise your form will not be submitted. If your form is submitted successfully, you will receive a confirmation email shortly after you submit your form. If you do not receive the confirmation, then we are not in receipt of your registration.
  
  Retreat Payment
  
  Amount:60.0
  
  Total:
  
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- Retreat Payment: $60
  
  MEN'S CORNERSTONE RETREAT
  
  If you did not make your payment online at the time of submission, you can mail your check to Notre Dame of Mount Carmel Church, Attention: Men's Cornerstone, 75 Ridgedale Avenue, Cedar Knolls, NJ 07927 or bring it downstairs to our parish office.

Notre Dame of Mt. Carmel

75 Ridgedale Ave. Cedar Knolls, NJ 07927
973-538-1358

Registration:
Men's Cornerstone XXV

Retreat Payment: $60

Registration: Men's Cornerstone XXV

Registration:
Men's Cornerstone XXV