Husband's Full Name (First,
Middle Initial, Last)
Husband's nickname
Wife's Full Name (First, Middle
Initial, Last)
Wife's Nickname
Address 1
Address 2
City
State
Zip Code
E-mail address
Phone Number
Wedding Date:
Husband's Religious Affiliation
and Church
Wife's Religious Affiliation
and Church
Select an experience or weekend
Select an alternate experience or
weekend
Do you have any special needs (diet, handicap, etc) so that we may accommodate you accordingly?
How did you hear about Worldwide Marriage
Encounter?
This is only a preliminary registration. To
guarantee your reservation please mail $50.00 non-refundable deposit to the
reservation couple (address below).
Please check here to state that you are mailing your deposit.
PRIVACY
INFORMATION:
Please
note for security purposes, when you submit this form, you will first be
directed to a Bravenet webpage asking you to verify that you intended to submit
information via the web. Worldwide Marriage Encounter uses the information you
submit for registration and to contact you for making your weekend together.
Your personal information will not be distributed outside of Marriage Encounter
or sold. Please note that the security of transmission of this information is
the same as any e-mail, and could potentially be intercepted. Please do not
provide any credit card numbers in this submittal.
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