Registration Form

Fill in the fields below and hit the Send button.
You will receive an e-mail shortly confirming the availability of the dates you selected and requesting a $75 non-refundable deposit. This deposit is good for one year transferable to another weekend in the event you need to cancel. Checks may be made payable to "WWME-Section 3".

If you wish to speak to someone directly about registration, call 610-449-1859.


Worldwide Marriage Encounter- Philadelphia Area Registration Form

*Husband's full name:

*Wife's full name:

*Address:

*City:
   *State:    *Zip:
County:    *Phone:    E-Mail address:
*Wedding Date:

*Religious Affiliation: His:     Church: 
*Religious Affiliation: Hers:  Church: 
   
*Which weekend?
August 6-8, 2010
November 12-14, 2010
 Alternate weekend date?
None
August 6-8, 2010
November 12-14, 2010

Any medical, physical, dietary restrictions or other information:
 
How did you find out about the Weekend?

How do you intend to pay the $75 registration fee? (payment instructions will follow)
Pay by check Pay online securely via Paypal
(Note: Paypal accounts allow use of payment by a credit card) In addition to the reservation fee, a donation is requested at the close of the Weekend to help with expenses. Worldwide Marriage Encounter is a non-profit orgnaization committed to enriching marriages throughout the world.

When finished, hit the Submit button.
To start over, hit the Clear button.

PRIVACY INFORMATION: Please note for security purposes, when you submit this form, you will first be directed to a Bravenet webpage asking you to verify that you intended to submit information via the web. World Wide Marriage Encounter uses the infomation you submit for registration and to contact you for making your weekend together. Your personal information will not be distributed outside of Marriage Encounter or sold. Please note that the security of transmission of this information is the same as any e-mail, and could potentially be intercepted. As such, please do not provide any credit card numbers in this submittal.


* = Required entry

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