2019 NC Regional Gathering Registration

Please fill out all the information below, then press the Submit button at the bottom of the page.

You will receive an email from sender "noreply@ecatholicnotifications.com" with confirmation of your registration (check your Spam/Trash folder if you don't see the confirmation).

If you don't receive an email confirmation, please contact Mike Harrison to confirm your registration. Thanks!

Name (Individual or Couple) REQUIRED Please fill out this field.

Childrens' Names

Names and Ages of all children attending

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

City/State REQUIRED Please fill out this field. Please enter valid data.

Transportation REQUIRED Please fill out this field.

Arrival and/or Departure times ONLY if different than Gathering beginning/end times

Special Needs (e.g. Dietary Restrictions, Handicap Access, etc. Specify "None" if not applicable) REQUIRED Please fill out this field.

Lodging REQUIRED I wish to stay at the Retreat Center I will make my own reservations at a local hotel Please fill out this field.

Hotel Room Sharing Please assist me in pairing up with another person to share the cost of a hotel room.

Lodging Comments

Financial Assistance for Registration/Housing/Travel REQUIRED I do not need financial assistance I request financial assistance I can also donate extra to help others attend, if needed Please fill out this field.

Dollar Amount of Financial Assistance Requested Please enter valid data.

WE NEED YOU! Ways you can help.

We need everyone to pitch in and help (exceptions of course for physical limitations, parents of young children, etc).

If this is registration for a couple, please have each person complete their own set of "ways to help" options. Otherwise, individuals please use the "Adult 1" forms only.

Name of Adult 1 (if this is registration as a couple) Please enter valid data.

Adult 1 - Other Help I Can Offer Please enter valid data.

Name of Adult 2 (if this is registration as a couple) Please enter valid data.

Adult 2 - Other Help I Can Offer Please enter valid data.

Additional Comments