Into the Deep 2016 Registration – CATHOLIC NEWMAN CENTER

Name:

Mailing Address:

Email

Number

What is the best way to be in contact with you?

Phone callTextEmailOther

I am a

current UMSL studentNewman community memberNewman staff memberother

How did you hear about Into the Deep?

Newman News / emaila friend/ word of mouthsaw an adFacebookother

My dietary preference is:

vegetarianveganwhatever-- I eat just about anythingIt's complicated-- please contact me

Medical Information

Do you have any medical conditions we should know about? Please describe in detail below.

Special Accomodations

Are you in need of any special accommodations of any kind? Please describe in detail below.

Please describe briefly why you want to go on this retreat at this time:

Thanks! Thank you for registering for Into the Deep! We can't wait to share this retreat with you! The cost for the overnight is $20/ person before Friday, Feb. 19th or $25 afterwards. You can pay in cash or check at the CNC or by mailing payment to 8200 Natural Bridge Rd., St. Louis, MO 63116, c/o Kay Dieckmann. Someone from the CNC will be in touch with you! PEACE!

Into the Deep 2016 Registration Form

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