subject_line
Retreat Registration
Retreatant Information
Which retreat are you registering for?
*
Father's Day Weekend Co-Ed Recovery
Other (Please indicate)
Other (Please indicate)
Is this your first retreat at White House?
*
Yes
No
Name
*
Email Address
*
Address
*
City
*
State
*
Zip
*
Phone
*
Date of Birth
*
+
Gender
*
Male
Female
If you are currently a member of a Parish, which one?
All meals are served family style. Do you have any dietary issues we need to be aware of? (For questions regarding this, please call our office at 314-416-6400)
All rooms are randomly assigned. If you require any special accommodations (i.e. need a first floor room), please let us know.
After finishing this page you will be sent to the payment page. A $50 non-refundable deposit is required in order to process your registration. Please note: This retreat is exclusively for people in 12-step recovery (alcohol).