Office for Life and Family, Archdiocese of Philadelphia

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

The Office for Life and Family is looking forward to being with you on the Life-Giving Wounds retreat October 23-25, 2026 at St. Mary of Providence Center (227 Isabella Road, Elverson, PA).

The following questions are important and help us to best minister to you on the retreat. Please answer them completely and accurately.

Qty

Description

Amount

Total

2026 Life-Giving Wounds Retreat (Private Room)

$375.00

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2026 Life-Giving Wounds Retreat (Shared Room)

$275.00

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Total: $0.00

Registration Information

First Name: *

Last Name: *

Email: *

Phone: *

Street Address: *

Address
City, State, Zip Code

Age: *

Emergency Contact Name: *

Emergency Contact Relationship to You: *

Emergency Contact Number: *

Emergency Contact Email: *

What is your religious affilitation? *

If you live in the Archdiocese of Philadelphia, what is your parish or college? *

If n/a, then put your city and state

Parent's relationship status: *

When did your parents divorce or separate?

(Don't know? Then put "unsure". Put n/a if not applicable).

How old were you?

Have you discussed your family wounds with a counselor, priest, or trusted friend? *

Yes or no: *

Do you feel emotionally and psychologically capable at this time to attend an event where strong emotional content about family life will be discussed, shared, and processed? (If you are seeing a counselor or psychologist, the please consult first with him or her about whether her or she believes it is a good time for you to attend a retreat like this one.)

Your relationship status: *