Talmeedo Men's Retreat Registration 2018

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Email *

First Name *

Last Name *

Age *

T-shirt size *

XXL

Date of Birth *

YYYY

Cell Number *

(Example: (xxx)-xxx-xxxx)

Street Address *

(Example: 1000 Seminary Rd)

City *

(Example: Dalton)

State *

(Example: PA)

Zip Code *

Parish Name and Location *

(Example: St. Thomas Orthodox Church, Lancaster, NY)

Emergency Contact Person *

(Example: First name, Last name)

Emergency Contact Number

(Example: (xxx)-xxx-xxx)

Waiver

I understand that at Talmeedo Men's Retreat, my phone will be collected and I will not have access to it throughout the duration of the camp. This is so that participants are able to focus on the retreat without any distractions. I also understand that photos that I am in may be used by the Northeast American Diocese, HTRC, and Talmeedo Men's Retreat for promotional purposes. *

I agree to these terms

Required

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