Candidate Registration

This registration form is for those interested in attending a Cursillo weekend. If you have any questions, please contact Grace Wiemann at 859-351-5995 or wiefam@icloud.com. If you prefer, you may download a printable form here and mail it in.

To reserve your room, we need to receive a $50 deposit. You may either pay online or by mailing a check. Instructions will be provided when you submit your registration. The deposit is applied to the total weekend cost, which includes three nights in a hotel, plus all meals and conference materials. The total cost is:

Double Occupancy – $170
Single Occupancy – $300
Student Rate – $150 (double occupancy only)

We realize that for some the total cost of the weekend might be prohibitive. Therefore, limited scholarships are available as our budget allows. Contact Grace Wiemann at 859-351-5995 or wiefam@icloud.com for information regarding available scholarships.

Name: *

Email Address: *

Phone Number: *

Mailing Address (street, city, state, zip): *

Date of Birth: *

How many years have you been a Confirmed Catholic?Can be approximate

Parish: *

Sponsor's Name (if you have one):

Are you married? *YesNo

Please enter spouse's name:

Is your spouse Catholic?YesNo

Has your spouse attended a Cursillo weekend?YesNo

Please list any other church-related activities you are involved in:

On Fridays, do you abstain from meat? *YesNo

Do you have any food allergies or other dietary needs? *YesNo

Please list your food allergies or other dietary needs:

Do you have any special physical or medical needs? *YesNo

Please list your special physical or medical needs:

Weekend Selection: *Women’s Weekend (January 16-19, 2025)Men’s Weekend (February 27 - March 2, 2025)

Room Selection: *Double Occupancy ($170)Single Occupancy ($300)Student Rate ($150)

For Double Occupancy, do you have a preferred roommate?

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