“A Walk in Jesus’ Shoes an Awakening Retreat”

Registration form:
November 6th - 8th, 2009, Lake Springfield, IL

Name _________________________ Phone __________________________

School Address _______________________________________________________

Permanent Address ___________________________________________________

E-mail Address _______________________________________________________

Denomination (optional) ___________________________

Home Parish ____________________________________

Diocese & City ___________________________________

Have you been on Awakenings before? ________ If yes, where? ________________

Do you have any special dietary needs? ____________________________________

Do you have any allergies? ______________________________________________

Emergency Contact (name and phone #) __________________________________

Are you willing to drive to Springfield? _____ If yes, how many fit in your car? _____

What is your T-shirt size? _____________________ (Optional, fee required).

When do you get out of class on Friday? ____________________

Cost is $45 (If cost is a problem, please see Sr. Claudia)

Appreciate Completed Registration forms by October 19th

Please bring registration forms and **money to the Dome (Sr. Claudia)
More infor call X3205 or email ccalzet@siue.de

**Scholarship money available--first come, first served! Speak to Sr. Claudia in

person at X3205.
Information about you ...

Year in school _____________ Major _________________________

Your favorite things:

Color ___________________

TV Show ___________________ Movie _________________________

Animal _____________________ Snack _________________________

Type of footwear __________________________

Song ______________________ Music Group ____________________

Book ______________________ Bible Verse _____________________

Quote ______________________________________________________

What is something interesting about you?

____________________________________________________________

What is something completely uninteresting about you?

____________________________________________________________

What do you like to do in your free time? ___________________________

List 3 words that best describe you ________________________________

Why did you sign up for Awakenings and what would you like to get from this
retreat?

_____________________________________________________________

_____________________________________________________________

Do you have any worries or questions about retreat?