Diocese of Sioux City

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

INTO THE GARDEN FAMILY REGISTRATION

Thank you for registering for the Lenten Retreat, Into the Garden. Please enter your registration & payment information below. Please note that this registration is for families only. All teens must be accompanied by a chaperone that is at least 21 years old. This can be an older sibling.

You can also reach out to your local parish to see if they are organizing a group to attend.

Qty

Description

Amount

Total

Student & Chaperone Registration

$40.00

---

Registration is $20 per person

Additional students

$20.00

---

Total: $0.00

Names of those attending

Student's Full Name:

Student's Grade:

Chaperone's Full Name:

Additional Name(s):

Additional Student's Grades:

Parish & City:

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: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *