| Hispanic Catholic Charismatic Center of Archdiocese of New York 826 East 166th Street Bronx N.Y. 10459 Tel: (718) 378-1734 - Fax: (718) 378-1819 |
Retiro Juvenil
Fecha de Nacimiento:_____/____/_____
Date of Birth:
Date of Birth:
Sex:__________________
Firma:_________________________
sign:
sign:
Apellido:_______________________
Last Name:
Last Name:
Direccion:__________________________________________
Address:
Address:
Apt:________
Ciudad:________________________
City:
City:
Estado:______
State:
State:
Codigo Postal:____________
Zip Code:
Zip Code:
Telefono:______ _____________
Parroquia:___________________________________________________________________________
Name of Church:
Name of Church:
Grupo a que pertenece:_________________________________________________________________
Grup that you belong to:
Grup that you belong to:
Retiros que has hecho: 1ra etapa 2da etapa 3ra etapa Pascua juvenil Dirigentes
Retreats you have done already: O O O O O
Retreats you have done already: O O O O O
Nombre:_______________________
Name:
Name:
Retiro que quiere hacer: 1ra etapa 2da etapa 3ra etapa Pascua juvenil Dirigentes
Retreat you want to do: O O O O O
Retreat you want to do: O O O O O
Fecha :_____/____/_____
Date :
Date :
| Por favor lea esto antes de Firmar No traer cosas de valor, ni prendas de ninguna clase, no somos responsables por valores perdidos. prometo permanecer estos tre dias de retiro obedeciendo las reglas de disciplinas, mantener limpio el establecimiento y poner atencion a las conferencias. |
| Please read this before sign Do not bring any valuables nor jewelry of any kind. we would not be responsible for any lost. I promise to stay these three days on the retreat, obey the rules, discipline, keep clean the rooms and attend the conferences. |
