Men's ACTS

March 7-10, 2019

St. Philip the Apostle Catholic Church

Men’s ACTS Retreat Application

This application is for registered St. Philip the Apostle parishioners only. Registration fee for parishioners is $150.00 and must be paid in full when using online registration.

If you are not a registered parishioner at St. Philip, or if you are a registered parishioner and wish to make payments ($50 deposit required), you can register by stopping by the office for an application during normal business hours (M-F 8:30am – 5pm). You can also request that an application be emailed to you by emailing the director at actsmen@stphilipcc.com. Registration fee for non-parishioners is $175.00.

Liability Waiver
I agree on behalf of myself, my heirs, successors, personal representatives and assign to protect, indemnify, save, and hold harmless the Diocese of Corpus Christi, St. Philip the Apostle Catholic Church and their officers, directors, agent,s employees, or representatives associated with the parish adult faith formation program from all damages, claims, suits, expenses and payment on account of or resulting from conditions stated on or resulting from any such injury, death, or damage to property, including resulting from the negligence of the Diocese of Corpus Christi, and parish, and or their officers, directors, and employees arising from or in connection with my attending adult faith formation events beginning July 1, 2018 and continuing through June 30, 2019.
Liability Waiver
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Retreatant Information
Name
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Preferred Name
Address
Preferred Phone --
Secondary Phone --
E-mail
Date of Birth //
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T-Shirt Size
Marital Status
Parish
Emergency Contacts/Health
Emergency Contact #1
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Phone --
Relationship
Emergency Contact #2
Phone --
Relationship
Do you have health issues requiring a special diet?
Do you have health issues, disability/conditions, or required medications that would affect your participation during the retreat?
If "Yes" to either question above, please explain:
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Payment
Payment in full required to register online. Registered Parishioners only.

Order Summary
Subtotal
Discount
Sales Tax
Shipping & Handling
Total

Payment Type
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Spam Capture
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Photography Consent
I understand that photos and video (individual and group) may be taken during the ACTS Retreat, and I give permission for my picture to be used for printed or online promotional materials. I understand that I am responsible to ensure I am not in any pictures or videos for which I have not consented.
Photography Consent
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