Regina Registration Form

Catholic Engaged Encounter Regina
Online Registration Form

Please note: Weekends are "first come - first serve", after sending
your email registration and receiving confirmation that there is room for you,
please send deposit immediately to:

Catholic Engaged Encounter
c/o Ron and Stella Anderson
375 Lockwood Road
Regina SK S4S 6E5

(a confirmation letter and map will be sent to you via email, fax or mail)
Please make cheque/money order of $320.00 payable to:
Catholic Engaged Encounter

Additional Information:
Weekends are $320.00 per couple (non-tax deductible).
This fee includes your accommodations and meals.
Weekend registration starts at 7:00pm with the first session beginning at 8:00pm.

Your "first" choice weekend date:

Your "second" choice weekend date:

Send confirmation letter to:

HER Information:

HIS Information:

First Name First Name

Last Name Last Name

Age Age

Address Address

City City

State/Province State/Province

Zip/Postal Code Zip/Postal Code

Country Country

Faith Faith

Occupation Occupation

Phone Phone

FAX FAX

E-mail E-mail

WEDDING Information:
Wedding Date
Parish / Church Name
Parish / Church Address
Priest
Additional information, like food allergies...
How did you here about the weekend?

HER Information:		HIS Information:
First Name		First Name
Last Name		Last Name
Age		Age
Address		Address
City		City
State/Province		State/Province
Zip/Postal Code		Zip/Postal Code
Country		Country
Faith		Faith
Occupation		Occupation
Phone		Phone
FAX		FAX
E-mail		E-mail