REGISTRATION

Program Registration

Please note:  Submit registrations at least 10 days before the program.

Please register me for (title of program):

Enter the date of the program:

If you are registering for a summer directed retreat, please indicate your previous retreat experiences below:

Registration Information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Commuter:

 Yes  No

Overnight:

 Yes   No

 Male    Female

Non-refundable, non-transferable deposit due: 


Need to check? Return to our full brochure.

Please Note: Each event description includes a cost amount and a deposit amount.  The cost is the full fee charged for attending the program.  If a deposit is indicated, it is required to reserve your place at the event and is non-refundable and non-transferable.  Xavier Center reserves the right to "close" any of our own programs which reach capacity, or to cancel programs for which there is insufficient registration.  In these cases deposits will be refunded. 

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