Cursillo Weekend Application

Cursillo Weekend Registration
Name

First NameLast Name
Nickname
Your Email
example@example.com
Your age
Cell Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have a sponsor?
Sponsor's Name

First NameLast Name
Sponsor's cell number
Sponsor's email
example@example.com
Name of church attending
Church affiliation
Like Roman Catholic, Methodist, Lutheran, Etc...
Are you married?
Name of Spouse
Spouse's cell
Please enter a valid phone number.Format: (000) 000-0000.
Please provide dietary restrictions or health information you think the leaders need to know about (Do you need a plug in for a CPAP, etc).
Registration is $100. Please pay at registration the first day of the weekend.

Weekend begins on Friday 8:00 AM until Sunday 3:00 PM
Should be Empty:

Cursillo Weekend Registration