Retreat Weekend Registration

Retreat Weekend Registration Form - November 7-9, 2025**
Couples must be married to register.

* Indicates required field

His name (preferred first name and last) *

First

Last

Her name (preferred first name and last) *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Today's date (yyyy/mm/dd) *

Do you have food restrictions (i.e., gluten-intolerant, allergies)? If so, list them below. *

Email *

2nd Email (if you each have your own) *

Phone number (xxx-xxx-xxxx) *

Date of marriage (yyyy/mm/dd) *

How did you hear about Marriage Encounter? *

Two worship services using Protestant liturgy are provided on the Weekend. What church do you attend, if any? *

Choose how you will participate in this Marriage Encounter experience
Couples have a choice to either stay in a double room at the Providence Renewal Centre with a private bathroom/shower or to return home each evening after attending all the sessions.

Indicate how you will participate *

We will sleep at the Providence Centre We will return home each evening

After you submit this form you will be taken to our payment page.
The registration fee is $150.00 per couple ($130.00 if you register by Friday, September 26th, 2025). Your registration fee will be refunded if you cancel by October 10th, 2025.

Indicate your payment method *

Option 1 - Credit Card Option 2 - Interac e-Transfer Option 3 - Cheque Option 4 - Gift

If your registration fee is a gift, then provide the name, phone number, and email address of who will be paying below: *

If you are paying the registration fee for another couple as a gift, then go to our payment page and follow the instructions. Only the attending couple needs to complete this registration form.

Registration deadline is Monday, October 20th, 2025

Submit

* If you click the submit button and are not taken to our payment page, then the above form is incomplete. Please complete the fields that will be highlighted and click the submit button again.

** Registrations are accepted or rejected at the sole discretion of Edmonton Anglican Marriage Encounter.

For more information please contact Heather & Garry Tansem (780) 974-8087 / [email protected]

Retreat Weekend Registration Form** - November 7-9, 2025Couples must be married to register.

Retreat Weekend Registration Form - November 7-9, 2025**
Couples must be married to register.