Lenten Retreat Check | Notre Dame Spiritual

First name

Last name

Address (Street #, Street Name, City/Town, State, Zip Code)

Telephone Number (###-###-####)

Gender

Female

Male

Marital Status

Single

Married

Vowed Religious

Emergency Contact Name and Telephone Number (First, Last, ###-###-####)

Health Needs (including allergies we should be aware of)

Previous Retreat History (where, when, how long, etc.)

After you click "Submit" please mail a check for $100 to the Notre Dame Spirituality Center at 30 Jeffreys Neck Road, Ipswich, MA 01938 to secure your registration. Thank you!