Cursillo Weekend Registration
Name
*
First Name
Last Name
Nickname
*
Do you have a sponsor?
*
Yes
No
Sponsor's Name
First Name
Last Name
Sponsor's cell number
*
Sponsor's email
*
example@example.com
Your Email
*
example@example.com
Cell Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of church attending
*
Church affiliation
*
Like Roman Catholic, Methodist, Lutheran, Etc...
Are you married?
*
Yes
No
Name of Spouse
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).
Please pay at registration the first day of the weekend.
Submit
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