Victoria Catholic Diocese Worldwide Marriage Encounter Registration Form

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To register for a Worldwide Marriage Encounter Weekend, print and fill out the form and mail to:

Milton & Diane Rejcek
2512 Hillcrest Dr
Bay City, TX 77414-7317
(979) 245-0323
register@mevictoria.org

 

Couple Information:

Name: ___________________________ & ________________________    __________________________
          (His)                                             (Hers)                                      (Last)

Address: ___________________________________________________

City: __________________________ State: _______________   Zip: ____________________

Phone: (_____ )____________________   Wedding Date: ____________________________

Weekend Desired: ____________________________  Alternate Date: ___________________________

Number of Children: _____________

Religious Affiliation:____________________________ (His) Church:_______________________________

Religious Affiliation:___________________________  (Hers) Church: ______________________________

 Please be sure to enclose your $50 Check to reserve your spot on the weekend.

Who told you about the weekend? ________________________________________________________

Make checks payable to:  "Worldwide Marriage Encounter"