RENEW Retreat Interest Form

Please fill out this form and click submit.

Name

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Phone

Address

What's the best way to contact you?

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Email Phone Call Text

Occupation

Have you participated in silent retreat before?

Please select all that apply.

Yes No

What are your personal reasons for wanting to go on retreat?

How many nights were you interested in staying for retreat?

Please give us three sets of dates, in order of preference, that you would like to have your retreat.

Please list the beginning and end dates for three options of when you would like to retreat.

If you know your travel plans (plane flight number, arrival & departure times etc...) please enter them here.

Our main retreat house has a small kitchen to prepare your own meals. There are also several options for meals close by to our regular retreat house. However, if you need pre-made meals and some groceries provided for an additional cost, please check the box below.

I need meals provided

Please select all that apply.

Yes No

We also can provide spiritual direction or pastoral counseling during your retreat time. Please indicate below if you are interested in adding these to your retreat time.

Please indicate your interest

Please select all that apply.

Spiritual Direction Pastoral Counseling

How often would you like to meet with a spiritual director or pastoral counselor?

Please select all that apply.

0 times - I do not need to meet with anyone Daily Once during retreat

If you have a specific focus for your retreat and would like us to suggest resources please share with us here in this space.

Please provide an emergency contact name and information below:

Name

Phone Number

Do you have any mobility, visual, and/or hearing restrictions that we should be aware of? If so, please indicate them here.

Where did you hear about the RENEW retreat?

The cost of our retreats ranges from $65 to $150 per night (not including spiritual direction) depending on location availability. If cost is a hardship, please click below to indicate your interest in a scholarship for this retreat.

I am interested in a scholarship

Please select all that apply.

Yes No

Description

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RENEW Retreat Interest Form

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