Name: ______________________________________________
Male/Female:_______________
Phone: __________________________ Cell Phone: _________________________
E-mail: ____________________________________________________________
Address: ___________________________________________________________
City: _____________________________ State: __________ Zip Code: ______________
I would like to register for: _____________________________________________________
I prefer a: _____ Private room ______ Shared Room _______ Neither, I'll commute
Roommate Name(s): ___________________________________________________________
The following special accommodations/diet are required: _________________________
___________________________________________________________________________
A non-refundable $60.00 deposit (unless another amount is specified) is required in order to complete your registration. Send this form and your deposit to:
Benedictine Sisters Retreat Center
Sacred Heart Monastery
916 Convent Road
Cullman, AL 35055-2019
Your canceled check will be your confirmation.