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CRHP Registration

- Our Faith

Christ Renews His Parish Retreat Registration

For more information, please contact one of the CRHP Coordinators directly
(instead of the parish office):

Men's Retreat

CJ Levy

c) 848-992-4528

cjlevy11@gmail.com

Women's Retreat

Kelley Karpinski

c) 317-709-3382

kelleykarpinski@yahoo.com
Register Here
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- Retreat Date REQUIRED Men's TBD Women's November 4-5 Please fill out this field.
- Title
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Nickname (for name tag) Please enter valid data.
- Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Home Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Country REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Are you a registered parishioner? REQUIRED Yes No Please fill out this field.
- Any food allergies or special needs? REQUIRED Yes No Please fill out this field.
- If yes, please note:
- Emergency Contact
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Alternate Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
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St. Catherine of Siena

Catholic Church

CRHP Registration

Christ Renews His Parish Retreat Registration

Register Here