Prince of Peace Parish

Lewiston • Lisbon Falls • Sabattus
Basilica of Saints peter & PAul
Holy Cross•Holy Family•Holy Trinity
Our Lady of the Rosary

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ACTS Retreat Registration

- Welcome to the ACTS Retreat
  REGISTRATION PAGE
  
  Hi, Please take a moment to fill out all the applicable spaces on our form. After submitting, within 7-10 days, you will receive a Welcome Letter which will include a packing list. Know that we all will be praying for you. We look forward to meeting you.
  
  If you have any questions please send an email to: [email protected]
  
  God Bless
- ACTS online registration
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  I am signing up for: REQUIRED Men's Retreat Women's Retreat Please fill out this field.
  
  Individual Information:
  
  I am a: REQUIRED Retreatant Team Member Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Name as you want it on a nametag: REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address: REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Birthday Month & Day REQUIRED Please fill out this field. Please enter valid data.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parish & City REQUIRED Please fill out this field. Please enter valid data.
  
  Will you have any specific dietary, medical, or physical needs during this weekend (ie., stairs, walking distances, allergic conditions such as scents, smoke, etc.)? Yes - Dietary Yes - Medical Yes - Physical No
  
  If yes, please describe:
  
  Tee Shirt Size: (Men's Retreat Only)
  
  Contact Person #1 (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.
  
  Email Contact Person #1 REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number Contact Person #1 REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Contact Person #2
  
  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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Other Comments:
  
  Pay Online Today190.0
  
  Paying by Check: Mail to ACTS Retreat, 607 Sabattus Street, Rear of Church, Lewiston, ME 04240.
  
  By clicking the Submit button below, I certify that I am 21 years of age or older.
  
  Total:
  
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