Marriage Retreat 2026

This form is to be filled out per couple. There will be payment required after you click "submit".

Church
Husband's Name Husband's Name First Last
Wife's Name Wife's Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Anniversary Date Anniversary Date / MM / DD YYYY
PAYMENT INFO

By selecting submit, you will be redirected to the payment page. A 3.5% Tax Fee will be applied at check out for debit / credit usage fee. Please note that by not finishing the payment, Impact Michigan will not receive the form and be able to count it as a full registration.