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Regnum Christi
Critical SF Information (HIDDEN)
Campaign ID
Registration ID
Contact ID
Early Bird Discount Amount
Amount on EB Period
DC 1
DC 1 Amount
DC 2
DC 2 Amount
DC 3
DC 3 Amount
Amount Due
PF Percentage
Fee
Total Amount
Event Cost
FA Total Amount
Contact Gender
Total Registered
PFAmount
Active?
Yes
No
Hide End Date?
Yes
No
OpenWaitlist
Yes
No
Early Bird Period?
Yes
No
Paid?
Yes
No
ManageReg
Yes
No
Discount Code?
Yes
No
Discount Code 2?
Yes
No
Discount Code 3?
Yes
No
Event Description?
Yes
No
Event Description 2?
Yes
No
Event Description 3?
Yes
No
Event Description 4?
Yes
No
Payment Information?
Yes
No
Event Location?
Yes
No
Kitchen Policy?
Yes
No
Event Address?
Yes
No
Location Directions?
Yes
No
Location Special Instructions?
Yes
No
Virtual Instructions?
Yes
No
Custom Question 1?
Yes
No
Custom Question 2?
Yes
No
Custom Question 3?
Yes
No
Includes Allergies?
Yes
No
Includes RC?
Yes
No
Includes First Time Type?
Yes
No
Includes First Time Location?
Yes
No
Includes Special Consideration?
Yes
No
Includes Referred by?
Yes
No
Includes Dietary Restrictions?
Yes
No
Includes Team Leader?
Yes
No
Pay at the Door?
Yes
No
With Donation?
Yes
No
Ask EC?
Yes
No
With Fee?
Yes
No
With PF?
Yes
No
Ask Parish?
Yes
No
Virtual?
Yes
No
With Cancellation?
Yes
No
With Partial Payment?
Yes
No
Mix Group?
Yes
No
Show Reg Info Box?
Yes
No
Track Adult Guests?
Yes
No
Track Adult Guests Names?
Yes
No
Track Youth Guests?
Yes
No
Track Youth Guests Names?
Yes
No
With Cancellation Policy Link?
Yes
No
Show Seat Capacity?
Yes
No
Include Gender?
Yes
No
FA Total
Registrant Number
Message
Auto-Responder Email
Registration Status
Event Planner
Event Planner Email
Event Logo Link
Thank You Page Link
Adult Group
Female
Male
Partial Payment Percentage
%
Cancellation Policy Link
Waiver
More
Percentage
%
Capacity
Stripe MA
DueAmount
DonationAmount
RegAmount
RegistrationAmount
Minimum Partial Amount
Error
Directions
More Info
Instructions
SPIRITUAL DIRECTION: Would you like to meet with a Spiritual Directer during your Personal Retreat Day? Please answer, YES or NO.
If you are not Catholic, please tell us what faith you practice.
Event
End Date
Start Date
Location
Address
V
irtual Event Link
Subheading
Home Phone
i.e. ###-###-####
x
The number of seats remaining for this event is:
Location Details
Location
Address
Directions
More Info
Kitchen Policy
Virtual Event Details
Virtual Event Link
Instructions
EVENT CLOSED
Sorry, this event has already closed. Thank you.
WAITLIST
This event is full. To be placed on the waiting list, please enter your contact information and submit this form.
REGISTRATION AND PAYMENT FORM
Use this form to manage your existing registration and/or complete your event payment.
Participant Information
First Name
Last Name
Email
Gender
Please select...
Female
Male
Mobile Phone
i.e. ###-###-####
x
Country
Please select...
United States
Canada
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos ( Keeling ) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Côte d ' Ivoire
Croatia ( Hrvatska )
Cuba
Cyprus
Czech Republic
Congo ( DRC )
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands ( Islas Malvinas )
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Prìncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands ( British )
Virgin Islands
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Country
Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Province
Please select...
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
State/Province
State/Province
Postal Code
Parish
Are you a Regnum Christi member?
Yes
No
Who is your Team Leader?
Emergency Contact Information
Full Name
Relationship
Mobile Phone
i.e. ###-###-####
x
Guest Information
Will you have additional guests attending with you?
Yes
No
If entering more than one person, separate each by semi-colons.
Total # of Adults Guests attending (including children ages 13 and over)
Only input the number of guests EXCLUDING yourself
Adult Guest Names
If entering more than one adult, separate each by semi-colons.
Total # of Children attending ages 12 and under
Names, Ages of Children
If entering more than one child, separate each by semi-colons.
Additional Information
Please list any dietary restrictions
Please alert us of any special needs
Allergies
How did you hear about us?
Will this be your first time attending this type of event?
Yes
No
Will this be your first time at this location?
Yes
No
Payment Details
$
You qualify for the early bird discount!
Registration Fee
$
Discount Code
Discounted Amount
Total Discount
$
Would you like to add a donation to your registration fee that will further support our mission of providing retreat experiences that bring souls closer to Christ?
Yes
No
$
Will you help us by covering the 3% processing fee on this transaction?
Yes
No
Payment Options
Partial Payment
Full Payment
Partial Payment Amount: You may increase your payment by editing the minimum amount shown.
$
Total Payment Due Now
$
Payment Type
Online
Pay by Check
Check Payment Instructions: Address to Mail Check to, etc.
Cancellation Policy
Requests to cancel or transfer registrations must be received at least 7 days prior to the event start date. Any cancellation will be subject to a non-refundable $75 processing fee. Please see our website for more details about our Cancellation Policy.
I have read and understand the cancellation policy.
Waiver Info
Waiver form text
Waiver form link label
Waiver pdf link
Include Waiver?
Yes
No
ASSUMPTION OF RISK AND WAIVER OF LIABILITY
Acknowledgement
I have read and understand the contents of the linked form in its entirety, and also understand that it is a legal document and I agree and consent to all terms and conditions contained within.
Signature
(Please type your first and last name)
Payment Card Information
Name on Card
Card Number
MM
YY
Code
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