Rachel's Vineyard Retreats

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Spanish Retreat: (Retiro en Español)
October 18-20, 2024 or
January 24-26, 2025.
Si tiene preguntas para el Retiro en Español, envíe un correo electrónico a Indhira García a [email protected]
God Bless You!
¡Que dios te bendiga!

Please register here:

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Select A Retreat Date: *

Your Name: *

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What is your Age? *

Address *

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City

State

Zip Code

Country

Email *

Email address where you can communicate confidentially?

Phone Number *

Number where you could be reached confidentially?

Emergency Contact *

First

Last

Who could we reach in case of emergency only?

Emergency #: *

ABORTION HISTORY:

Number of Abortions: *

Time since last Abortion: *

Other Reproductive losses? *

Miscarriage, Stillbirth, Infertility...

ReLIGIOUS AFFILIATION?

Religious background *

Do you attend church now? *

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PERSONAL info:

Allergies or diet restrictions? *

Need special accommodations? *

Are you now or have you ever, received professional counseling? *

How did you hear about us? *

Internet Search Church bulletin Friend / Word of Mouth Informational Poster The Catholic Witness Rachel's Vineyard Website Diocese of Harrisburg Website Undefeated Courage Website Restaurant Placemat

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Home
ThankYou
Abortion Pill Reversal
Abortion Healing
- Rachel's Vineyard Retreats
Events