Pre-retreat Questionnaire

Name *

First Name

Last Name

Mobile Phone *

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

When do you plan to arrive? *

Saturday - Special arrangements required

Sunday Morning

Sunday Afternoon

Sunday Evening

Other

When do you plan to depart? *

Thursday Evening

Friday Morning

Friday Afternoon

Friday Evening

Saturday - Special arrangements required

Retreat track I'm seeking to participate in *

Intensive

Post-Intensive

Mix of Both

Unsure

Special Food Requests *

Select all that apply

Gluten-free

Vegetarian

Vegan

None

How did you learn about this Retreat? *

Select all that apply

Christian Contemplative Experience (CCE) at Holy Family

Other Holy Family Communication

Contemplative Outreach of CT

Contemplative Outreach Ltd web listing

Other Contemplative Outreach chapter

Friend/Colleague invitation

Other