Registration Form – Married Lovers Retreat

Step 1 of 3

2026 MARRIED LOVERS RETREAT REGISTRATION | FALL

PRIMARY CONTACT

Name *

First

Last

Primary Contact Email *

Primary Contact Mobile Number *

COUPLE'S INFORMATION

Couple's Last Name *

Wedding Anniversary *

If newlyweds, indicate the date you were married.

Retreat Attendance *

Please indicate the total number of years the couple has attended the retreat, including the current year.

SPOUSE INFORMATION

Husband's Name *

First

Last

Husband's Name Tag Preference *

(e.g. The husband's name is Anthony; the husband prefer to be called, "Tony".)

Husband's Meal Preference *

Wife's Name *

First

Last

Wife's Name Tag Preference *

(e.g. The wife's name is Kathryn; the wife prefers to be called, "Kate".)

Wife's Meal Preference *

ADDRESS INFORMATION

Address *

Address Line 1

Address Line 2

City

State

Zip Code

EMERGENCY CONTACT INFORMATION

Emergency Contact *

Emergency Contact*

Please check this box to complete your emergency contact information. Indicate any details required for contacting your emergency contact in the Emergency Contact Instructions section below.

Method Meal Name

PAYMENT

Retreat Package Options *

*Full Payment or a deposit is due upon registration. The deposit is non-refundable. The balance is due by October 22, 2026.

Payment Method *

Zelle®
Check*

COMMENTS

Questions / Comments