NIK Retreat Registration Form

NIK 57: November 14 - 16, 2025
A COLLEGE RETREAT TO:
- Grow closer to God
- Experience community
- Connect faith and life
- Make new friends
- Rest
Please provide all required information to register for NIK weekend.

Retreat Cost: $50.00
Registration will be on a 1st come, 1st served basis.
More details will be e-mailed to you closer to the retreat.
Registration deadline is 1 week before retreat.
Please bring payment to the Newman parish office or pay online using link at the submission of this form.
Name*

First NameLast Name
Birth Date*

MonthDayYear
Date
E-mail*
Cell Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
College/University*
Year in School
Major
Expected Date of Graduation

MonthDayYear
Date
Religion
How did you hear about this retreat?
I have a car & can drive to retreat
Number of Seat belts
Special Needs - i.e. Diet, allergies, medications, etc.
Emergency Contact Name*
Relationship
Emergency Contact Phone Number*
Emergency Contact Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you on the NIK Team?

YesNo
Questions or anything else that we should know.
When you hit submit registration it will direct you to the Give Central page if you wish to pay using your credit card.

If you wish to pay with cash or check, please just close out of Give Central. Your registration will be submitted. Please then bring cash/check to the office.
To be completed by Office Staff

Down Payment Date ____________ Payment Date ______________

Cash _______________ Check Number _____________

Paid in Full _______________ Financial Assistance _______________
Should be Empty:

NIK 57: November 14 - 16, 2025