UOCC YOUTH AND YOUNG ADULT
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Western Eparchy Young Adult Retreat
St. Anthony's UOCC Edmonton AB - June 22-23 2018
*
Indicates required field
Name
*
First
Last
First and Last Name
Age
*
Must Be Over 18.
Gender
*
Male
Female
Phone Number
*
Email
*
Emergency Contact Name
*
The Name of your Emergency Contact.
Emergency Contact Phone
*
The Phone Number of your Emergency Contact.
Allergies and/or Pertinent Medical Information
*
Allergies or Medical Information we should know. Put "N/A" if none.
Name of Parish
*
The name of the Church you attend.
Jurisdiction
*
The Orthodox jurisdiction you belong to. (Ukrainian, Antiochian, Greek, Russian, etc..)
Fee and Payment
Fee:
The fee for the retreat is $100.
Payment:
Payment can be made by Cash or Check.
Please make Check's out to "Ukrainian Orthodox Church Of Canada Western Eparchy".
Please bring the funds with you to the retreat as the fee will be collected during registration on the first day of the retreat.
I hereby agree that the above information is correct and that I will conduct myself as a responsible adult and Orthodox Christian
*
I Agree
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