Registration Page - Worldwide Marriage Encounter - Delaware and Eastern Shore of Maryland

If you are interested in attending a Marriage Encounter, please complete the form below

Husband's Full Name (First, Middle Initial, Last)

Husband's nickname

Wife's Full Name (First, Middle Initial, Last)

Wife's Nickname

Address 1

Address 2

City

State

Zip Code

E-mail address

Phone Number

Wedding Date:

Husband's Religious Affiliation and Church

Wife's Religious Affiliation and Church

Select an experience or weekend

Select an alternate experience or weekend

Do you have any special needs (diet, handicap, etc) so that we may accommodate you accordingly?

How did you hear about Worldwide Marriage Encounter?

This is only a preliminary registration. To guarantee your reservation please mail $50.00 non-refundable deposit to the reservation couple (address below).

Please check here to state that you are mailing your deposit.

PRIVACY INFORMATION:

Please note for security purposes, when you submit this form, you will first be directed to a Bravenet webpage asking you to verify that you intended to submit information via the web. Worldwide Marriage Encounter uses the information you submit for registration and to contact you for making your weekend together. Your personal information will not be distributed outside of Marriage Encounter or sold. Please note that the security of transmission of this information is the same as any e-mail, and could potentially be intercepted. Please do not provide any credit card numbers in this submittal.

If you have any further questions or you would like to speak to someone personally please call

A $50 non-refundable deposit is required to confirm your registration.

Send your deposit (a check payable to "Worldwide Marriage Encounter") to :