October 23-25, 2026

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address 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.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Please List any Allergies

Emergency Contact Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Relationship to Retreatant REQUIRED Please fill out this field. Please enter valid data.

Room Preference REQUIRED 1st Floor 2nd Floor No Preference Please fill out this field.

Suite mate preference (if known) Please enter valid data.

Room # preferred (if known) Please enter valid data.

Religious Affiliation Catholic Baptist Presbyterian Methodist Episcopalian Lutheran Protestant Jewish Other

Age Demographics 21 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 90+

Name of Church Parish Please enter valid data.

Retreat Payment

A non-refundable $100.00 deposit is required to secure your registration and will be applied towards your final payment. The full payment includes the deposit amount. If you pay the deposit only, your balance will be due upon check-in for your retreat.

Retreat Payment:

100.0 – Deposit only (Non-refundable)

350.0 – Payment in Full

Donation Opportunities:

All donations received above the full cost of your retreat are considered tax deductible. Donations help us with general operating expenses. Gifts to our Capital Improvements Campaign help us to beautify our facility and address deferred maintenance issues. Thank you for supporting our ministry!

Donations $ Please enter a positive decimal.

Capital Improvements $ Please enter a positive decimal.

Lynette Johnston Baton Rouge 225- 772-0990	Brittany Manuel Ville Platte 337-831-3477
Mary Ann Caillouet Thibodaux 985-227-2311 Cindy Steib Lottie 225-718-1801	Pat Trahan Harahan 504-737-2592