Men's Sign Up Page

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  Retreat REQUIRED Please fill out this field.
  
  Retreatant Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Name for ID Badge Maximum 20 characters
  If you would like to be called a different name than what is entered above, please provide it here.
  Please enter valid data.
  
  Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Secondary Phone Number Maximum 20 characters Please enter a phone number.
  
  Address REQUIRED Please fill out this field.
  
  Shirt Size REQUIRED Please fill out this field.
  
  Parish / Church REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital Status Married Single Not Specified
  
  Dietary Restrictions Please enter valid data.
  
  Optional Message
  
  Emergency Contact Information ( 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.
  
  Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Secondary 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.
  
  Each retreat is staffed with previous retreatants who volunteer their time and cover their own costs. The retreat is a non-profit event where costs are kept to a minimum. The cost for the retreat is $ 475.00 including all meals, accommodations and supplies required.
  
  Someone from the retreat team will contact you to make payment arrangements.
  
  Thank you
  Welcome to ACTS!
  
  Submit
  
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