Joyful Women's Retreat Registration Form
WHERE: Immaculate Heart of Mary Catholic Church, Hays, Kansas WHEN: Friday, October 2nd @ 6:30 p.m. thru Saturday, October 3rd at 3:00 p.m.
Your Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Parish & City, State
*
Guest 2
First Name
Last Name
Parish & City, State
Email Address
Phone Number
Guest 3
First Name
Last Name
Parish & City, State
Email Address
Phone Number
Guest 4
First Name
Last Name
Parish & City, State
Email Address
Phone Number
# Registrations
Please Select
0
1
2
3
4
Registration Total Amount
Check Payment
Checks Payable to Immaculate Heart of Mary (Memo: Womens Retreat) Mail or Drop Off to the IHM Parish Office 1805 Vine Street Hays, KS 67601
VENMO Payment Only (Complete the following)
prev
next
( X )
Registration Charge
$40.00
$
40.00
Quantity
1
2
3
4
Payment Methods
Choose from one of the PayPal options to
make your payment.
Submit
Should be Empty: