ACTS Retreat Registration | St. Francis of Assisi Wichita KS

Register below for the upcoming ACTS Retreat.

Retreat Weekend(Required)

Women's Retreat

Men's Retreat

Name(Required)

First Last

Preferred Name for Name Tag(Required)

Email(Required)

Enter Email Confirm Email

Primary Phone Number(Required)

Secondary Phone Number

(if available)

Can we text the Primary Phone Number provided above?

Yes

No

Address(Required)

Street Address Address Line 2 City State ZIP Code

Your Home Parish(Required)

If other, please specify

T-shirt Size(Required)

Any allergies or dietary concerns?(Required)

Do you have any mobility concerns or problems navigating stairs?(Required)

(Elevators are available)

Yes

No

Emergency Contact

First Emergency Contact's Name(Required)

First Emergency Contact's Relationship to You(Required)

First Emergency Contact Phone Number(Required)

First Emergency Contact's Email Address(Required)

Second Emergency Contact's Name

Second Emergency Contact's Relationship to You

Second Emergency Contact Phone Number

Second Emergency Contact's Email Address

Official Enrollment

This registration form serves as your official enrollment, however, your spot will not be fully reserved until payment is received. The full cost is $250 for parishioners of St. Francis of Assisi and $300 for non-parishioners. The cost can be divided into two payments, with the initial $150 due to reserve your spot and the balance due a week prior to the retreat. Please indicate your preferred payment method below.

Preferred Payment Method(Required)

Cash or Check (we will arrange payment with you)

Online (payment link will be provided after you submit your registration)