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Christ Renews His Parish Online Registration
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If you prefer not to register online or have
additional questions or problems, please contact the church
at 804-527-1037, Patrick Snyder at 804-553-1024, or Pam Kelly at 804-714-8870.
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Retreat Date
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First Name
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Last Name
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Nickname (for nametag)
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Street Address
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City
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State
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Zip Code
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E-mail Address
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Home Phone Number
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Are you a registered parishoner?
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No Yes |
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Any food allergies,
special hotel room preferences, or other special needs?
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No Yes (if yes, please indicate below) |
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Questions/ Comments
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Emergency Contact Information:
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Name (first and last)
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Relationship (spouse, sibling, etc.)
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Home Phone Number
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Cell Phone Number
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Work Phone Number
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