Please print clearly the following information:
Groom's Name:_______________________________________________
Address:_____________________________________________________
City:_______________________State:________Zip:__________________
Telephone:(H)______________________(W)________________________
Religion:_______________________________________Age:__________
Parish:______________________________________________________
Location:____________________________________________________
1st marriage:yes________no_______ Children: yes_______no________

Bride's Name:_________________________________________________
Address:______________________________________________________
City:_______________________State:______Zip:_____________________
Telephone:(H)______________________(W)_________________________
Religion:________________________________________Age:__________
Parish:_______________________________________________________
Location:______________________________________________________
1st marriage:yes______no______ Children: yes________no_____________

Person who recommended Engaged Encounter:_______________________
Anticipated Date of Wedding:______________________________________
Preparing Priest or Deacon:_______________________________________
Date of Weekend Desired:________________________________________

Mail this completed registration form, along with your payment to:

Marriage, Family & Respect Life Ministry
623 S. Wolcott
Casper, WY 82601

Make checks payable to Catholic Engaged Encounter.