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Road to Emmaus RETREAT REGISTRATION

October 13-15, 2023
- Click HERE for details regarding this wonderful spiritual opportunity!
- Retreat Payment Instructions:
  
  You may process your $200 retreat payment online at the time of registration. You may also drop off your check at our Parish Office. Please make checks payable to Notre Dame of Mt. Carmel Church and note "Emmaus 2023" on the memo section of your check. Bless you!
- Registration Form
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address 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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Best Phone Number to reach you REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Please note any special needs: Please enter valid data.
  
  Emergency Contact Details
  
  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 Please enter valid data.
  
  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.
  
  Retreat Payment200.0
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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- Contacts:
  
  Questions? Please contact
  Bob Waters / watersro1@gmail.com - 336-423-8937