Comedy Couples Waitlist – 2022 All fields are required to submit application. Retreatant Information: First name(Required)Last Name(Required)Cell #(Required)Email(Required) Birthdate(Required) Parental Information [This portion is required for ECRC records]If mother is deceased please click here Yes Mother's First Name(Required)Mother's Last Name(Required)Mother Cell #(Required)If father is deceased please click here Yes Father's First Name(Required)Father's Last Name(Required)Father Cell #(Required)Mother or Father Email(Required) Address(Required) Street Address City State / Province / Region ZIP / Postal Code Two Foundations Retreat Girls Cost(Required) Full Amount of $300 2 Payments of $150 Enter Coupon Code (If any)There is certain behavior and certain expectations that are encouraged on the journey. I understand that this journey is to focus on my personal relationship with God. I agree that if I am found in possession of or participating in any way with drugs or alcohol, I will be sent home immediately at my expense. I further understand that this is a Catholic Chaldean retreat and I am expected to participate in all planned meetings and activities and abide by all rules. By checking this box, I am agreeing with all terms mentioned and all my information that I completed above is true.Terms & Conditions(Required)Check this box after reading the above terms. For the Parent/Legal Guardian ONLY First Name(Required)Last Name(Required)Today's Date(Required) Total Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name Δ
