Name
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First Name
Last Name
Best email for correspondence
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
We only collect this information to follow up with you if we have any questions about registration or payment.
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(Arch)Diocese/College
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When did your parents' divorce or separate? (Don't know? Then put "unsure.")
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How old were you?
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Are any family members, significant others, or friends attending this event with you? If yes, whom?
Have you discussed your family wounds with a counselor, priest, or a trusted friend?
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We believe our retreat is a great complement to counseling, spiritual direction, and/or ongoing conversation with trusted friends. Knowing this information helps us to best serve you during the retreat.
Do you feel emotionally and psychologically capable at this time to attend an event where strong emotional content about family life will be discussed, shared, and processed?
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If you are seeing a counselor or psychologist, then please consult first with him or her about whether he or she believes it is a good time for you to attend a retreat like this one.
Please list any food allergies/sensitivities or any other special diet requirements.
Is there anything else you feel would be helpful to share with the team leadership at this time or would like to share with us?
How did you hear about the retreat?
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