Diocese of Phoenix - CRM ANNUAL CONFERENCE

REGISTRATION FORM
Contact Person or Group Leader Information *

Prefix/TitleFirst NameLast NameSuffix
E-Mail Address*
Phone Number*
Group Name (Optional - Not Required)
NOTE: PLEASE READ AND FOLLOW THESE STEPS:

(Please register youth and adults separately). Youth registration includes Lunch and Dinner.
1.) Please select the number of people you are registering from the dropdown below. Select “1” if you are only registering yourself.
2.) Enter 1, and registration information in the fields below, and CLICK the "ENTER" button to submit the information provided. Skip the email field if it's the same as the contact person above.
3.) If you are registering more than one, enter 2, 3, 4, etc. in the # field, fill in the info. (Emails are optional), and click "ENTER" after every entry.
4.) The numbers selected below should match the number of the added registrants.
# Of Persons Registering*
Please check the item selection and match the numbers of people entered above with the "Quantity" dropdown below. Adult meal reservation available below.

$25.00 SUPER "EARLY" REGISTRATION (Age 18 and over)$25.00

$25 SUPER Early Regular Registration - ENDS December 31, 2025.

Quantity

Dinner Meal$12.00

Dinner meal includes a grilled Hamburger or Cheeseburger or 2 hotdogs, Soda, and Sides. Provided by the SJV Youth Ministry's Fundraising Team.

Quantity

$25.00 YOUTH EARLY REGISTRATION (INCLUDES LUNCH & DINNER) $25.00

Early Registration ends - Dec 31, 2025. Youth Retreat - Sat, May 2nd, 9AM-9PM Grades 6 - 12 (Middle & High School age).

Quantity

ALL RELIGIOUS$ Free

Priests, Deacons, Sisters, Brothers, Seminarians, and Nuns

Donations (Optional)$5.00

Please click the dropdown arrow to select your donation level and amount. Thank you for your generous donations!

Level

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Registration Payments are Non-Refundable.

Yes, I understand that Registration Payments are Non-Refundable. I confirm that the amount paid corresponds to the number of registrants. By registering to this event, you are granting the Diocese of Phoenix permission to use your likeness in photograph, video, other digital media.
For REGISTRATION QUESTIONS, please TEXT or CALL:

"H" Walsh at (406) 210-7867 or Laurie Walsh at (623) 670-1120

E-Mail: azmtbriwal@gmail.com

or E-Mail: Cathy Cato at: tewcatz@hotmail.com
Should be Empty:

REGISTRATION FORM