Marital Retreat Registration Form

April 29-30, 2022 | The St. Athanasius Family Ministry will be hosting our first annual Coptic Orthodox Southern Diocese Marital Retreat, which will be held in Titusville, FL.

Registration price includes accommodations for one night, three meals (breakfast, lunch, and dinner), and professional child care (if registered).

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Adult Registration

Couple (i.e., 2 Adults) ($150) Single Person ($90)

Amount

Number of Children (4y and up)

0 ($0) 1 ($35) 2 ($70) 3 ($105) 4 ($140)

Amount

Number of Children (0-3y)

0 ($0) 1 ($0) 2 ($0) 3 ($0) 4 ($0) 5 ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

April 29-30, 2022

The St. Athanasius Family Ministry will be hosting our first annual Coptic Orthodox Southern Diocese Marital Retreat, which will be held in Titusville, FL.

Registration price includes accommodations for one night, three meals (breakfast, lunch, and dinner), and professional child care (if registered).

Please Fix the Following

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