St. Vincent Martyr

26 GREEN VILLAGE ROAD
Madison, NJ 07940

973-377-4000

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Alpha - Wait List

- The maximum number of form submissions has been reached. This form is currently not available.
  
  You are accepted onto the wait list. You will be contacted when a space opens for this Retreat.
  The first 45 applications have been registered for the retreat. The next will be waitlisted. You will be notified if you are on the waitlist.
  
  Anne Marie Gisoldi, Director of Youth Ministry
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent 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.
  
  School, Grade, and Age REQUIRED Please fill out this field. Please enter valid data.
  
  Medical/Psychological Concerrns Please enter valid data.
  
  Medication being taken Please enter valid data.
  
  Allergies we need to know about Please enter valid data.
  
  If you are interested: Parents sometimes donate food for the retreat. Individual packaged desserts - bring when you come Individual packaged snacks: pretzels, chips, etc. Bring when you come Cans of Soda or bottles of water
  
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