Married Lovers Retreat Registration – Wait List

NOTE: Thank you for your interest in the Married Lovers Retreat. We’re so glad you want to join us! Unfortunately, we have to waitlist new registrants at this time. Please complete the form and submit it. We will contact you ASAP and let you know the availability to attend this year’s event. Thank you.

Step 1 of 3

PRIMARY CONTACT INFORMATION

Primary Contact Name *

First

Last

Primary Contact Email *

Primary Contact Mobile Number *

COUPLE'S INFORMATION

Couples Last Name *

Wedding Anniversary *

Please enter the wedding anniversary date. If newlyweds, enter the wedding date.

Years Attending the Retreat *

SPOUSE INFORMATION

Husband's Name *

First

Last

Husband's Name Tag Preference *

First Name or Nickname

Husband's Cell Number *

Husband's Meal Preference *

Wife's Name *

First

Last

Wife's Name Tag Preference *

First Name or Nickname

Wife's Cell Number *

Wife's Meal Preference *

ADDRESS INFORMATION

Address *

Address Line 1

Address Line 2

City

State

Zip Code

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.

PAYMENT

Payment Amount *

Full Payment of $750.00 USD is due upon registration and is non-refundable. Payment will only be accepted once the venue has space available. We will send a payment link the Primary Contact’s cell and/or email.

Name of Organization/Person Sponsoring Couple *

Please list the name of the church/organization providing the discount payment for attendance at the retreat.

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