Our Lady Queen of Heaven

Registration Form

Our Lady Queen of Heaven Women’s ACTS Retreat

St. Charles Retreat Center Lake Charles, LA

September 14th-17th, 2017

ACTS is an acronym for Adoration, Community, Theology and Service. The retreat’s goals are to strengthen our faith and its application in our daily life, to renew ourselves spiritually and to build strong lasting friendships. The ACTS weekend is presented by lay Catholic women, with support provided by a Spiritual Director and clergy. The retreat begins Thursday evening, September 14, with check-in at 6:00 P.M. at Our Lady Queen of Heaven Family Life Center Activity Room. Transportation to and from the retreat center will be provided. We will return to Our Lady Queen of Heaven Church, Sunday, September 17, for the 11:00 A.M. Mass with a reception following the Mass in the Family Life Center Activity Room.

Space on the retreat is limited and as awareness has increased, so has the desire to attend. In an effort to eliminate long waiting lines, a lottery system has been put into place. You no longer need to line up early. Preference will be given to registered OLQH Parishioners. The full cost of the retreat is $250.00. This registration form, with a $100 deposit made payable to “Our Lady Queen of Heaven ACTS” must be presented during registration to reserve your space on the retreat. Remaining balance will be due at the Thursday evening check-in. Deposits will not be refunded for cancellations made within two weeks of the retreat. Please note: A fund has been established to provide registration assistance for retreat attendance. If you have financial concerns, a limited number of scholarships are available for each retreat. Please note your need on your registration form.

ACTS is a parish-based retreat and ministry. Registration will begin Saturday, July 29th after all Masses for two full weekends. Registration will close on August 11th.

To be considered as a retreatant, applicants must meet the following criteria:

1.) Must be a Roman Catholic registered as an OLQH parishioner and tithing to OLQH for 6 months prior to ACTS retreat enrollment period.

2.) Once the slots for the retreat have been filled with those applicants stipulated in #1, then it will be open to Roman Catholics of the 38 parishes of the Diocese of Lake Charles.

3.) After that, if there are any openings, Roman Catholics in the dioceses of the Province of New Orleans will have the opportunity to attend the retreat.

4.) After that, any non-Catholics may submit their application for review to the pastor.

Registration forms will be accepted for women age 21 and over. Anyone who does not register during the open registration will be put on a waiting list and will be contacted as space is available. When the retreat is full, a waiting list is maintained until the day of the retreat to fill any vacancies, those remaining on the waiting list are returned their deposits and are asked to register again for the next retreat.

You will receive a letter about two weeks prior to the retreat describing the necessities you should bring on the retreat. If you need further information or have any questions, please contact one of the Directors listed:

Bridget Robideaux, Director: 337--802-0026

Jo-Anne Rogers, Co-Director: 337-661-5916

Carol Camara, Co-Director: 337-356-7022

Fr. Ruben Buller, Spiritual Advisor

(COMPLETE THE FORM ON THE NEXT PAGE)

Please turn in registration form and $100 deposit to the OLQH Church Office by August 11th.


Please register me for the Women’s ACTS retreat, September 14-17, 2017. Enclosed, please find my registration:

(Circle one) Deposit of $100.00 Full Fee of $250.00

NAME (please print )_________________________________________________________________________________

ADDRESS: _________________________________________________________________________________________

CITY____________________________________ STATE___________ ZIP_________________

SINGLE______________________ MARRIED_______________________ AGE_________________

YOUR EMAIL: _______________________________________________________________________________________

HOME PHONE: _______________________________ CELL PHONE: _____________________________

CHURCH WHERE YOU ARE REGISTERED AND ATTEND_______________________________________

If OLQH parishioner, your envelope number______________________

DO YOU REQUIRE SCHOLARSHIP ASSISTANCE? _________________ FULL OR PARTIAL?

TSHIRT SIZE (S, M, L, XL, XXL, XXXL) _____________________________________________________

SPOUSE’S NAME___________________________________________________________________________________

SPOUSE’S EMAIL___________________________________________________________________________________

SPOUSE’S CELL PHONE: __________________________ SPOUSE’S WORK PHONE: ______________________

DO YOU HAVE ANY SPECIFIC MEDICAL OR DIETARY NEEDS DURING THE WEEKEND? IF YES, PLEASE EXPLAIN:

_________________________________________________________________________________________________

__________________________________________________________________________________________________

DO YOU SMOKE? _________________________

PLEASE GIVE US AN EMERGENCY CONTACT FOR SOMEONE WHO DOES NOT LIVE WITH YOU:

EMERGENCY CONTACT NAME: ____________________________RELATIONSHIP TO YOU: __________________

CONTACT HOME PHONE: ____________________________CELL PHONE: _______________________

EMERGENCY CONTACT WORK PHONE: ____________________________

EMERGENCY CONTACT EMAIL: ____________________________________