Burning Hearts Young Adult Retreat

Personal Information

• * First Name:
• * Last Name:
• * Address 1:
• Address 2:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:
• * Phone:
• * Email Address:
• * Confirm Email Address:
• Parish & City

• Promo Code

  Enter Code: Apply

• Fee

  Type	Fee
  Private Single Room (One person)	$250.00
  Shared Room (2 People, price per person - married couples or same-sex roommates)	$175.00

• *Please note that the Retreat Center does not assign roommates. Those electing to register for a shared room are responsible to find a roommate. (i.e. spouse, family member, or friend)

Dietary Needs & Assistance

• Dietary Need:

  • Vegetarian
  • Gluten-Free
  • Plant-Based/Vegan
  • Dairy-Free
• Extreme food allergies, please note here:

• Do you require special assistance?

  • ADA Room (Americans with Disabilities Act)
  • 1st Floor Room (For those with limited mobility)
• If you selected an ADA room and/or 1st floor room, please describe your ADA needs/requirements.

Guest Information

You may add a maximum of 1

Photograph and Video Consent

• Photograph and Video Consent: From time to time, pictures and video may be taken of Archbishop Brunett Retreat Center Retreatants. We would like to be able to use these photographs and videos for flyers, Archdiocesan publications, and the Retreat Center website. Written consent of the Retreatant (and, if retreatant is under 18, the parent/guardian) is required. Names will not be posted unless written authorization is given by the retreatant and parent/guardian, and then only first names will be used. If there are concerns about pictures or videos posted on the website, please contact the organization or webmaster, and they will promptly be removed.

• *

  I (if applicable, the parent/guardian of this retreatant), authorize and give full consent, without limitation or reservation, to The Archbishop Brunett Retreat Center to publish any photograph or video in which the above named Retreatant appears while participating in any program associated with the Retreat Center. There will be no compensation for use of any photograph or video at the time of publication or in the future.

  • I authorize and give my full consent.
  • I do not authorize or give my full consent.

Payment Notes

• Fee includes all presentations, six meals and two nights in a comfortable room with private bath.

• Retreat payments are refundable, minus a $25 administrative fee, up to 5 days before the start of the event. You may also transfer the fee to another person or choose to donate it to our scholarship fund. Fees may not be rolled over to a future event. All cancellations must be received by email or in writing.

• After you enter your credit card information, please only click the “Pay Now” button once to prevent duplicate charges to your card. Thank you!

• Payment notes: