RETREAT REGISTRATION FORM

  Please complete the form on - line or ...
 if you would like to register by mail, print a copy of the completed form
and mail to the address below to register for a program(s). 

 On-Line Registration:

Click on the Register Now button below, complete contact, event and charge card information on our secure transmittal system.

      I have read Mercy Prayer Center Financial Policy and understand the terms

By Mail Registration:

Contact Information:

First Name:    Last Name:
 Address:      
 City:            State:  Zip:
 Home Phone:         Work Phone:     
 Email:          

Retreat Information:

                       Date:
                       Date:
                  

 Send completed form and check to:       

 Mercy Prayer Center
65 Highland Ave.
Rochester, NY 14620