St Thomas' Shrine Mont Parish Retreat Registration 2022

St. Thomas 2022 Parish Retreat Registration Form

We're excited that you are able to join us for this year's parish retreat at Shrine Mont! Please fill out the form below to reserve your spots. If you have any questions about the retreat, please email Spencer Ballou at ballou5@verizon.net
Number of people in your group attending *
Please list the name and ages of all whom you are registering:
Name *

First Name Last Name
Age *
Pronouns
Name

First Name Last Name
Age
Pronouns
Name

First Name Last Name
Age
Pronouns
Name

First Name Last Name
Age
Pronouns
Name

First Name Last Name
Age
Pronouns
Name

First Name Last Name
Age
Pronouns
Name

First Name Last Name
Age
Pronouns
Name

First Name Last Name
Age
Pronouns
Please provide some contact information so we can confirm and communicate with you:
Please provide a contact E-mail address *
example@example.com
Please provide a contact mobile phone number *
Is this your first time attending a St. Thomas' Parish Retreat? *
Are there any accessibility needs or other things you'd like us to know to help best accommodate your family? Please be sure to include any important information about food allergies or diet restrictions.
For which meals during the retreat will you be able to join us?

Friday 9/30 Dinner Saturday 10/1 Breakfast Saturday 10/1 Lunch Saturday 10/1 Dinner Sunday 10/2 Breakfast Sunday 10/2 Lunch At this point, we are unsure of exactly which meals we can attend
Please select the payment options that work best for your family and calculate your total
With support from St. Thomas', the prices for room and board are discounted from the actual Shrine Mont costs! Please use these sliders to calculate what the total cost for your family will be. *
Please select how you would like to make your payment: *
If you would like to request scholarship assistance for up to 3 members of your family, please select the number needed below.
Final step - please submit your payment by choosing the items below for which you are paying at this time:
My Products
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DEPOSIT ONLY - All attendees ages 4 & up
$ 25.00 Number of Attendees Ages 4 & up

PAY IN FULL - Adults (Ages 19 & up)
$ 150.00 Number of Attendees Ages 19 & up

PAY IN FULL - Youth (ages 13-18)
$ 100.00 Number of Attendees Ages 13-18

PAY IN FULL - Children (Ages 4-12)
$ 50.00 Number of Attendees Ages 4-12

Children (Ages 3 and under)
Free Number of Attendees Ages 3 and under

SHARE THE SHRINE Share the Shrine is a parishioner-supported offering to assist those who otherwise may not be able to attend. Donations of all sizes are welcome – thank you for your support!
$ 1.00 Enter the amount you would like to contribute (in $)

Total

$ 0.00
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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St. Thomas 2022 Parish Retreat Registration Form