NAME

Gender

Male
Female

Date of Birth

Phone Number

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Age

Sweatshirt Size

Are you willing to be a driver in a car pool?

Do you need a ride to the retreat?

Emergency Contact Information

Phone Number to Contact in Case of Emergency

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Emergency Contact's Name and Relation to Participant

Special Medical or Dietary Requirements

I assume responsibility for my own actions and safety on the retreat and therefore release the UMBC Catholic Retrievers and Archdiocese of Baltimore of any liability which may arise from my participation in this retreat.*

Registration For Fall Retreat $75.00

Payment

Information Form

Emergency Contact Information

Registration For Fall Retreat $75.00

Billing Information