Check One: Awakening (First Time)     Team     Growth (Already been on Awakening)

Name:

Phone (include area code):

Current Address:    Zip:

Email Address:

Date of Birth:

Please check box if you will allow us to contact your parents/family to pray for you while you're away that weekend.

Parent's Name:

Parent's Phone Number (include area code):

Dietary Needs (if any):

T-shirt Size:

Even though you can submit your registration online, you'll still need to pay your retreat fee ($35) to Kay ASAP.
*Make checks payable to Catholic Newman Center-UMSL. Space not reserved until payment is received!
Questions: Contact Kay at 314-385-3455 or cnc@cncumsl.org