Christ the Redeemer

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Kolbe Prison Ministry Retreat

" I was in prison and you came to visit me..." Matthew 25:36

Sign up for or donate to the Kolbe Prison Retreat at the Pack Unit.

Description

Amount

Total

Kolbe Prison Ministry Retreat

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The cost of the retreat is $100 which
covers meals, supplies, and other costs
(does not include lodging, if required)

General Donation to this Ministry

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Give to help offset the costs of putting on
these ministry retreats.

An additional 3.5% will be added to your fee to cover the processing costs.

Total: $0.00

participant information

First Name: *

Last Name: *

Date of Birth: *

Email address: *

Home Address: *

Address 2:

City: *

State: *

Zip Code: *

Phone Number: *

Emergency Contact: *

Emergency Contact Phone: *

Please detail food allergies, dietary restrictions, or special needs:

Consent to Participate and Liability Release:

I agree on behalf of myself, my heirs, successors, and assigns to indemnify, defend, and hold harmless Christ the Redeemer Catholic Parish and the Roman Catholic Archdiocese of Galveston-Houston, their employees and/or volunteers from any and all claims (unless due to the Sole or Gross NEGLIGENCE of the Parish) for illness, injury, death, and the cost of medical treatment therewith, arising from or in any way connected with my attending this retreat. In the event any legal action is taken by either party against the other party to enforce any of the terms and conditions of this release, it is agreed that the unsuccessful party to such action shall pay to the prevailing party therein all reasonable court costs, reasonable attorneys’ fees and expenses incurred by the prevailing party.

I have read this statement, and I understand and voluntarily agree to its provisions.

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *