Retreat Application Mens Emmaus Retreat 2026 September 18-20, 2026 CommentsThis field is for validation purposes and should be left unchanged.A three-day spiritual renewal experience in English based on "The Appearance on the Road to Emmaus" from the Gospel Luke 24:13-35 For Catholic Men ministered by Catholic Men (Must be at least 21 years old to attend this retreat)Name(Required) First Last Name on Badge(Required) First Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email(Required) Enter Email Confirm Email Primary Phone(Required)Secondary PhoneMarital Status(Required) Single Engaged Married Divorced Widowed Religion?(Required)Parish?Occupation(Required)Date of Birth(Required) Month Day Year Emergency Contact InformationEmergency Contact Name:(Required) First Last Relationship:(Required)Primary Phone(Required)Secondary PhoneAdditional QuestionsI heard about Emmaus from:Do you know anyone coming to this Emmaus?(Required) Yes No If so, who?Please provide any dietary restrictions, allergies, or physical limitations that we should be aware of:Do you smoke?(Required) Yes No Polo Shirt Size(Required) Small Medium Large X-Large XX-Large Retreat will be held at St. Andrew Catholic Church, 9950 N.W. 29th St., Coral Springs – Transportation is provided to and from hotel. RETREAT STARTS: Friday, September 18th at 5:30 pm with a Meet & Greet at St. Andrew Social Hall RETREAT ENDS: Sunday, September 20th between 2:30 - 3:00 pm with a Wrap Up at St. Andrew Social Hall. Please tell your family and friends to meet in the hall for special wrap-up. COST: $175..00 – Includes all meals, lodging, and transportation. A non-refundable $25 Deposit is required with the application. Payment in full is due by Friday, September 4, 2026. (Please do not let the lack of funds prevent you from attending this Emmaus Retreat. Scholarships are available.) Payment InformationPayment(Required) Non-Refundable Deposit - $25 Full Payment - $175 Optional Donationhelp to offset the cost Amount Due: Billing E-mail Address:(Required) Enter Email Confirm Email Billing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name IMPORTANT NOTE: The use of cell phones during the retreat will be very limited. During the retreat there will be a phone available in case of any emergencies. For questions, please contact one of the following: Keith Nicoll 954-554-3217 or Tom G 954-817-9702