St. Joseph Catholic Church

	CRHP Retreat Registration  Please fill out the form below, to register for the next St. Joseph's Christ Renews His Parish Retreat.  If you should have any questions, please contact:  Dorothy Renton:  drenton@stjoseph-libertyville.org
	We ask participants to pay a $55 fee to help defray the cost of the weekend. After registering here, please submit payment to the parish office.  However, no one is ever turned away due to an inability to pay. Scholarships are available.  Thank you.

Please provide the following information:

First Name

Last Name

Street Address

City

State   Zip

Home Phone      Work Phone  

 Email address

I would like to register for the:

Choose a retreat here...Women's Retreat - March 13-14, 2010Men's Retreat - April 24-25, 2010Women's Retreat- September 25-26, 2010Men's Retreat- October 23-24, 2010Women's Retreat- March 19-20, 2011Men's Retreat- April 30-May 1, 2011

Emergency Contact Name (other than self)

Emergency Contact Daytime phone  

Emergency Contact Evening Phone

Emergency Contact Email address

Your T-shirt size (S, M, L, XL, XXL)

Any special dietary needs?

Comments/questions?