Membership Retreat 2021 Registration form

Membership Retreat 2021

For members of the Schoenstatt Mothers' League
Your Name *

First Name Last Name
Your Email
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
I assume all responsibility for myself for any illness or accident while attending the workshop or retreat *

Emergency contact person

Phone #
You can either pay online via PayPal with the link below or send a check payable to Schoenstatt Sisters of Mary

Address:           Schoenstatt Center

                        Att’n: Schoenstatt Mothers’ League

                        134 Front Street

                        Rockport, TX 78382-7800
Please bring along: Linen, towels, personal items, items needed for protection like face masks or face covers, hand sanitizer, etc. Given the situation of the virus we also ask you, kindly to bring blankets along if needed. We will not be providing blankets or bedspread due to our shortage of personnel to wash all items after every use. Thanks!

Remember to bring your Membership consecration prayer, your Scepter celebration, your Heavenwards.

Total fee (including $10.- pre-registration fee): $ 130.–

For security due to COVID-19 we will have only single room setting available.
Please check the following questions:
Do you have COVID-19? *

Yes No
Are you convalescent of COVID-19? *

Yes No
Have you been exposed to someone infected with it? *

Yes No
Have you traveled or plan to travel outside the country 14 days prior to the retreat? *

Yes No
Do you have a cough? *

Yes No
Do you have fever or chills? *

Yes No
Do you have a sore throat? *

Yes No
Do you have shortness of breath or difficulty breathing? *

Yes No
Do you have fatigue? *

Yes No
Do you have muscle or body aches related to a possible COVID-19 contagion? *

Yes No
Do you have headaches? *

Yes No
Do you have a new loss of smell or taste? *

Yes No
If you have responded with yes to any of the above questions we ask you to stay at home for your sake and the sake of all other participants.
During the retreat we will follow the regulations, using face masks and keeping social distance. If necessary, participants will be screened for elevated temperature before entering the retreat house.

Thank you for your understanding!
If you are in need of a special diet due to health reason, please write down what you need. Thanks!
To pay the pre-registration fee online please select the following option, otherwise continue to the next field and make sure to mail in your fee. Thank you!
Registration
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Pre-registration fee Pre-registration fee to secure your place. Non-reimbursable The $0.59 are for the online transaction fee.
$ 10.59

Total

$ 0.00
Date

Month Day Year
Date
Signature *
By typing your name you are sending a digital signature in agreement to all of the above. Thank you!
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