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Weekend retreat for parents whose children have died

- We will be holding a weekend retreat
  Oct. 13-15 at the Spiritual Renewal Center in Victoria. Please save the dates if interested.
  
  Join us for a grief weekend for parents whose children have died of any age, for any reason, whether your loss is recent or in the past. This weekend includes time to for prayer, reﬂection, listening to speakers, clergy, counselors, and grieving parents.
  
  Participants will have the opportunity to share their own story or simply remain silent if they prefer. The retreat will take place at the beautiful Spiritual Renewal Center in Victoria, Texas, a place where many have found renewed hope and healing. In addition to this retreat, we also oﬀer monthly grief support meetings.
  
  * Partial financial assistance may be available for those who cannot afford the registration cost.
  
  Check in at 4 p.m. on Friday. Concludes Sunday afternoon.
  
  SCROLL DOWN TO REGISTER BY MAIL OR ONLINE.
  
  If you have any questions, please contact:
  
  Patricia Hoelscher 979-257-9984, phoelscher@victoriadiocese.org
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- Mail in registration form Click to download and print.
Register online here
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  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Spouse's Name (if attending) Please enter valid data.
  
  Mailing Address Line 1 REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address Line 2 Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Spouse's Email Please enter an email address.
  
  Home Phone Number Maximum 20 characters Please enter a phone number.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Spouse's Phone Number Please enter valid data.
  
  Do you or your spouse have any dietary restrictions? If so list here. REQUIRED Please fill out this field. Please enter valid data.
  
  Information about Child
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date of death REQUIRED Please fill out this field. Please enter valid data.
  
  Information about Child
  
  Name Please enter valid data.
  
  Date of birth Please enter valid data.
  
  Date of death Please enter valid data.
  
  Information about Child
  
  Name Please enter valid data.
  
  Date of birth Please enter valid data.
  
  Date of death Please enter valid data.
  
  Emergency Contact #1 (someone not attending retreat) First and Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #1 (someone not attending retreat) Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #1 Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #2 (someone not attending retreat) First and Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #2 (someone not attending retreat) Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #2 Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything that you would like us to know about you as we prepare for the retreat?
  
  Room Choice A $100 deposit is required with registration. Balance can be paid on day of retreat. REQUIRED 265.0 – Individual 198.0 – Shared room (2 per room, paying for one person) 396.0 – Paying for 2 in shared room 100.0 – Pay deposit now, balance later. Please fill out this field.
  
  Requested roommate (if not already included in form) Please enter valid data.
  
  Would you like to donate? Add amount here. $ Please enter a positive decimal.
  
  Total:
  
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