Life-Giving Wounds Retreat Registration CommentsThis field is for validation purposes and should be left unchanged.Contact DetailsName(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Age(Required)Religious Affiliation(Required)Select OneCatholicProtestantUnaffiliatedOtherParish(Required)Select OneAll Saints – DunwoodyCathedral of Christ the King – AtlantaCentro Catolico Mission – Sandy SpringsChancery – SmyrnaChrist Our Hope – LithoniaChrist Our King and Savior – GreensboroChrist Redeemer – DawsonvilleCorpus Christi – Stone MountainDivino Niño Jesus Mission – DuluthGood Samaritan – EllijayGood Shepherd – CummingHoly Cross – AtlantaHoly Family – MariettaHoly Spirit – AtlantaHoly Trinity – Peachtree CityHoly Vietnamese Martyrs – NorcrossImmaculate Heart of Mary – AtlantaKorean Martyrs – DoravilleMary Our Queen – NorcrossMost Blessed Sacrament – AtlantaOur Lady of LaSalette – CantonOur Lady of Lourdes – AtlantaOur Lady of Perpetual Help – CarrolltonOur Lady of the Americas Mission – LilburnOur Lady of the Assumption – AtlantaOur Lady of the Mount – Lookout MountainOur Lady of the Mountains – JasperOur Lady of Vietnam – RiverdalePrince of Peace – Flowery BranchPurification – SharonQueen of Angels – ThomsonSacred Heart – GriffinSacred Heart – MilledgevilleSacred Heart of Jesus – HartwellSacred Heart of Jesus Catholic Basilica – AtlantaSan Felipe de Jesus Mission – Forest ParkShrine of the Immaculate Conception – AtlantaSt Andrew – RoswellSt Andrew Kim – DuluthSt Ann – MariettaSt Anna – MonroeSt Anthony – AtlantaSt Anthony – Blue RidgeSt Augustine – CovingtonSt Benedict – DuluthSt Bernadette – CedartownSt Brendan – CummingSt Brigid – Johns CreekSt Catherine Laboure Mission – JeffersonSt Catherine of Siena – KennesawSt Clare of Assisi – AcworthSt Clement – CalhounSt Elizabeth Seton Mission – Warm SpringsSt Francis de Sales – MabletonSt Francis of Assisi – BlairsvilleSt Francis of Assisi – CartersvilleSt Gabriel – FayettevilleSt George – NewnanSt Gerard Majella – Ft. OglethorpeSt Helena Mission – ClaytonSt James – MadisonSt James the Apostle – McDonoughSt John Neumann – LilburnSt John the Evangelist – HapevilleSt John Vianney – Lithia SpringsSt Joseph – AthensSt Joseph – DaltonSt Joseph – MariettaSt Joseph – WashingtonSt Jude the Apostle – Sandy SpringsSt Katherine Drexel Mission – TrentonSt Lawrence – LawrencevilleSt Luke the Evangelist – DahlonegaSt Marguerite D’Youville – LawrencevilleSt Mark – ClarkesvilleSt Mary – RomeSt Mary – ToccoaSt Mary Magdalene – NewnanSt Mary Mission – ElbertonSt Mary Mother of God – JacksonSt Matthew – TyroneSt Matthew – WinderSt Michael – GainesvilleSt Michael – WoodstockSt Monica – DuluthSt Oliver Plunkett – SnellvilleSt Patrick – NorcrossSt Paul of the Cross – AtlantaSt Paul the Apostle- ClevelandSt Peter – LaGrangeSt Peter Chanel – RoswellSt Peter and Paul – DecaturSt Peter the Rock – The RockSt Philip Benizi – JonesboroSt Pius X – ConyersSt Stephen the Martyr – LilburnSt Theresa – DouglasvilleSt Thomas Aquinas – AlpharettaSt Thomas More – DecaturSt Thomas the Apostle – SmyrnaSt Vincent de Paul – DallasTransfiguration – MariettaOther Event DetailsParents Relationship Status(Required)Select OneDivorcedSeparatedMarried with high conflictAnnulledCohabitation dissolutionNever marriedOtherYour Relationship Status(Required)Select OneMarriedSeparatedDatingSingleDivorcedAnnulledAnnulled and remarriedConsecrated religiousPriestAre any family members, significant others, or close friends attending this event with you?(Required) Yes No If yes, who?Have you discussed your family wounds like a counselor, priest, or trusted friend?(Required) Yes No Do you feel emotionally and psychologically capable at this time to attend an event where strong emotional content about family life will be discussed, shared, and processed? (If you are seeing a psychologist, then please consult first with him or her about whether he or she believes it is a good idea for you to attend a peer group like this one.)(Required) Yes No Do you have any food allergies the retreat team should be aware of?(Required) Yes No Food allergiesIs there anything else you feel would be helpful to share with the leadership team at this time?If you are in need of financial assistance or are a clergy or religious, please contact Patrick at pmetts@archatl.com Dates Attending May 30th – St. Catherine of Siena Parish, Kennesaw – Topic: Grief and recovering one’s faith and identity August 1st – St. Peter Chanel, Roswell (with Dr. Dan Meola) – Topic: Relationships – anger and anxiety November 7th – Our Lady of the Assumption, Brookhaven – Topic: Forgiveness and redemptive suffering May 30th – St. Catherine of Siena Parish(Required) Price: August 1st – St. Peter Chanel Catholic Church(Required) Price: November 7 – Our Lady of the Assumption Catholic Church(Required) Price: Payment DetailsTotal This field is hidden when viewing the formSTotalCoupon Credit Card(Required) Step 1 of 3 33%
