Please select your choice of Weekend dates

Please enter the name(s) of the individual(s) who have invied you to the Weekend

Please enter the phone number of the individual(s) listed above

Please enter husband's preferred first name. This will be printed on the name tag during the Weekend.

Please enter wife's preferred first name. This will be printed on the name tag during the Weekend.

Please enter your last name

Please enter the wife's last name ONLY if it is different from husband's last name

Please enter your home address

Please enter an alternate phone number (cellular, work, etc.)

Please enter your primary email address

Have you previously been on a Marriage Encounter Weekend?

Please enter husband's faith preference

Please enter husband's church or parish

Please enter wife's faith preference

Please enter wife's church or parish

Please tell us how you found our about us and the Weekend

Please let us know any information that may be helpful to us in providing for your comfort. These may be allergy or medical conditions, or other information you think important for us to know.

Please let us know if you have a smoking preference. Note that this is for hotels only.