MEW Registration

Marriage Encounter Weekend

May 3 - 5, 2004 Lestonnac Retreat Center, Tustin
We wish to begin the journey of enhancing our relationship as Husband and Wife by experiencing the Marriage Encounter (M.E.) Weekend. Please add our names and the information we provided herein to the roster of Candidate Couples.

Fields marked (*) are required. All other information is purely voluntary in nature that will only facilitate communication. The information provided here is strictly confidential and for MEMC use only. It is not to be released or divulged to any party outside of the MEMC Organization unless permitted in writing by the couple concerned.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How were you married?*

Catholic ChurchCivil CeremonyOther
Please define "Other"
Wedding Date*

MonthDayYear
Current Parish Name blanks* and Location blank
Emergency Contact Name blanks* Phone Number Area Code* Phone Number*
Name of Children and Age(s)
Referred By

First NameLast Name
If not referred, how did you learn about us?

Parish BulletinWebsiteOther
Please define "Other"

Spouse's Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
E-mail*
example@example.com
Phone*
Have you been COVID vaccinated?*

YesNo
Signature*

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Marriage Encounter Movement of California
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MEW Registration CostMay 3 - 5, 2024
$250.00 Quantity

Total

$0.00
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The payment is ready! It will be completed once you submit the form.
Please make check payable to MEMC and mail it with your completed Registration Form to:
4195 Chino Hills Parkway, Suite 442, Chino Hills, CA 91709, or you may submit them to your Referring Couple.

In case of cancellation, full refund will be made if cancelled 7 days prior to start of the event. MEMC reserves the right to cancel the event in accordance with our policies and guidelines. Candidates will be notified of cancellation at least 7 days prior to the event.
For further information, please call us at: (909) 529-6959 or visit our website at www.memconline.org
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Marriage Encounter Weekend