Online Registration
Newly Wed Retreat 

Church Information
* Church Name
* Church City
* Church State
* Church Priest
Applicant's Information
* First Name
* Last Name
* Telephone
* E-mail Address
* Name of Spouse
Mailing Information
* Street Address
* City
* State
* Zip Code
Emergency Medical Information
Emergency Contact Person
Contact Person’s Phone:
Additional Phone (Cell, Pager):
Doctor’s Name:
Doctor’s Phone Number:
Insurance Company:
Insurance Policy #:
Any special circumstances regarding the participant (allergies, etc.):
*Required Fields
The registration process will be complete upon receiving your payment. Please, make check to: St. Mary and Archangel Michael  indicating in the memo: 2008 Newly-Wed Program. Please, fill another form for your spouse. Send payment to: Fr. Daoud Tawadrous 1016 Kerwood Circle Oviedo, FL 32765