505-863-4406
media@dioceseofgallup.org
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505-863-4406
media@dioceseofgallup.org
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Engaged Encounter Retreat Registration
This registration covers food and expenses for the Engaged Encounter Retreat Weekend
Choose an Option
Registration, Lodging Included - $85.00
Registration, No Lodging - $50.00
Registration Now, Pay Later - $0.00
Payment Day:
1st of the Month
2nd of the Month
3rd of the Month
4th of the Month
5th of the Month
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19th of the Month
20th of the Month
21st of the Month
22nd of the Month
23rd of the Month
24th of the Month
25th of the Month
26th of the Month
27th of the Month
28th of the Month
Payment Day:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Make my first payment today
For the Man: First Name for the Certificate
*
This field is required.
Last Name for Certificate
*
This field is required.
First Name for Name Tag:
*
This field is required.
Last Name for Name Tag:
*
This field is required.
Email:
*
We need a valid email.
Address:
*
This field is required.
City:
*
This field is required.
State:
*
This field is required.
Zip Code:
*
This field is required.
Phone:
*
This field is required.
Age:
*
This field is required.
Religion:
*
This field is required.
For the Woman: First Name for the Certificate
*
This field is required.
Last Name for the Certificate
*
This field is required.
First Name for Name Tag:
*
This field is required.
Last Name for Name Tag:
*
This field is required.
Email:
*
We need a valid email.
Address
*
This field is required.
City
*
This field is required.
State
*
This field is required.
Zip Code
*
This field is required.
Phone
*
This field is required.
Age
*
This field is required.
Religion
*
This field is required.
Support Contact for the Man:
This field is required.
Please give the name of a friend or family member who supports and prays for the success of your marriage (If you do not have this information yet, just leave these fields blank).
Support Contact for the Woman:
This field is required.
Please give the name of a friend or family member who supports and prays for the success of your marriage (If you do not have this information yet, just leave these fields blank).
Parish to be married in:
*
This field is required.
Wedding Date:
*
This field is required.
Priest/Pastor Name:
*
This field is required.
Address after wedding:
*
This field is required.
City
*
This field is required.
State
*
This field is required.
Zip Code
*
This field is required.
Special Needs: (dietary, physical impairments or medical issues that require accommodations)
This field is required.
Which weekend do you desire?
*
April 10-11, 2021
June 26-27, 2021
October 23 - 24, 2021
This field is required.
For those requesting lodging at the retreat center please select one:
Select
Staying only Saturday night
Staying Friday and Saturday night
This field is required.
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Continue to Payment
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Payment
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