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Life Giving Wounds Registration

- Formation
  - Upcoming Formation Events
    
    Children's Liturgy of the Word
    Activated Discipleship
    Vacation Bible School
    Life Giving Wounds
    
    Life Giving Wounds Registration
    
    Catholic Conference - A Light For My Path
    A Light for My Path Sponsorship
  - Youth
    
    Youth Faith Formation
    Faith Formation Schedules
    Siouxland Youth Group
    Quinceañera
    Out of Sequence, Back on Track (OOSBOTs)
  - Adult
    
    Discipleship
    J1:38
  - Newman Center
    
    Mater Dei's Newman Center
  - Family
    
    Family Small Group Leaders

Come for a greater understanding of the wounds left by your parents' divorce or separation, for advice concerning love and trust of others, and for an experience of Christ and community that will lead to a deeper self-understanding and healing!

Learn more about this retreat. Click on this text to hear Fred Shellabarger's interview on Siouxland Catholic Radio in February 2024. This year's retreat is similar to the March 2024 retreat.
The maximum number of form submissions has been reached. This form is currently not available.
- These questions are important so we can best minister to you on the retreat, and it helps us form small groups.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- In case of an emergency, please provide the following information so we can contact them if needed.
- Emergency Contact's First Name REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Thank you for providing that information. Please continue filling out the form for yourself.
- Age Range REQUIRED Please fill out this field.
- Religious Affiliation REQUIRED Please fill out this field.
- Name of Catholic Parish you belong to (Put NA if non-Catholic) REQUIRED Please fill out this field. Please enter valid data.
- Parents' Relationship Status REQUIRED Please fill out this field.
- Your Relationship Status REQUIRED Please fill out this field.
- Are any family members, significant others or close friends attending this event with you? If yes, whom? REQUIRED Please fill out this field.
- Have you discussed your family wounds with a counselor, priest, or trusted friend? REQUIRED Yes No Please fill out this field.
- If you are seeing a psychologist, then please consult first with him or her about whether he or she believes it is a good idea for you to attend a peer group like this one.
- Do you feel emotionally and psychologically capable at this time to attend an event where strong emotional content about family life will be discussed, shared and processed? REQUIRED Yes No Please fill out this field.
- Do you have any food allergies or food restrictions the retreat team should be aware of? REQUIRED Please fill out this field.
- Is there anything else you feel would be helpful to share with the team leadership at this time?
- Scholarships are available to those who need assistance covering the cost. Please contact Jeff Schoep at 712-251-6465 or [email protected] to apply.
- Payment REQUIRED
  250.0 – per person
  150.0 – Students Age 18-25
  150.0 – Military (past or present)
  150.0 – Seminarian or Novice
  0.0 – I will apply for a scholarship Please fill out this field.
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