Private Retreat Registration | Notre Dame Spiritual

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Registration for Private Retreat in June 2025

First name*

Last name*

Email*

Address*

Phone Number*

Gender*

Female

Male

Marital Status

Single

Married

Vowed Religious

Emergency Contact Name*

Emergency Contact Phone Number*

Are there any health needs including allergies we should be aware of?*

What is your previous retreat history, i.e., where, when, how long, etc.?*

What are your food preferences? (Select all that apply)*

Regular Diet

Vegetarian

Vegan

Gluten Free

Dairy Free

Please select the nights you will be staying by checking the box to the left of the date.

Monday June 9th

Tuesday June 10th

Wednesday June 11th

Thursday June 12th

Pay Deposit of $100 with Credit Card or Mail Check to Notre Dame Spirituality Center, 30 Jeffreys Neck Road, Ipswich, MA 01938

Deposit$100

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