OURSHIP MARRIAGE RETREAT REGISTRATION

Thank
Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Preferred Method of Contact*

EmailPhone CallText MessageOther
Birthdate*

MonthDayYear
Date
Spouse's Name*

First NameLast Name
Spouse's Birthdate*

MonthDayYear
Date
How many years married?*
Wedding Anniversary*

MonthDayYear
Date
How many Children do you have ?*
Total all kids between both parents
How many boys/girls?*
Please list gender and ages
What is your Love Language?*

Words of affirmationActs of serviceGiftsQuality TimePhysical TouchI don’t know
What is your spouse's Love Language?*

Words of affirmationActs of serviceGiftsQuality TimePhysical TouchI don’t know
What will be your relationship focus? Check All that Apply.*

Blended FamilyCommunicationFinancesParentingSocial Media BehaviorOther
Are you a Couple-Prenuer (in business together)?*

YesNoConsidering itTried but weren't successfulWilling to try againOther
Will you be celebrating anything during our trip?

BirthdayAnniversaryOther
Describe your perfect date night in as much detail as possible.
Travel Information
Are you interested in attending our welcome event one day before the cruise (hotel included)?*

YesNoMaybe
Do you have valid passports?

Yes! We're ready to go!I do, my spouse doesn'tOh no, we need to do that
Would you like assistance securing flights to Miami?*

YesNoMaybe
Departure Airport
If not flying, put Driving from (city)
Anyone require handicap accessible accommodations, have special needs, dietary restrictions, allergies, or medical concerns?
Example: We need a wheelchair accessible room, child allergic to peanuts, etc. If multiple rooms - please indicate which
Will you know any other couples attending the cruise? If so who and would you like to room near each other? If anyone is military, please indicate so here.
Any other Requests, Preferences, or Information you'd like to share?
Example: We prefer to fly first class on Delta, ocean views, and a king size bed, etc.
Please verify that you are a human.*
Should be Empty:

Travel Information