REGISTRATION TO ATTEND A HEART OF ILLINOIS VIA DE CRISTO WEEKEND

SECTION I. REGISTRANT INFORMATION (Please print and fill in completely, especially the bolded areas.)

Name				Birth Date		Home Phone				Work Phone
Address		City						State			Zip
Marital Status Married ( ) Divorced ( ) Single ( ) Widowed ( )	Spouse’s Name		Spouse’s Work Phone				Number of Children		Nickname (IF YOU WANT IT USED)
Church You Attend and Denomination					Your Pastor’s Name
Church Address		City						State			Zip
Personal E-Mail Address

Weekends are held in the Spring and Fall of each year. Please indicate which one you plan to attend.

Spring - East Bay Camp ( ) Fall - East Bay Camp ( )

YES NO

( ) ( ) Has Via de Cristo been explained to you?

( ) ( ) Has Group Reunion been explained to you?

( ) ( ) Do you have any special dietary requirements? (Please explain.)

( ) ( ) Do you require medication at a specific time each day? (Please explain.)

( ) ( ) Do you have health/physical restrictions requiring special equipment /facilities? Special sleeping

needs, no stairs, CPAP machine? (Please explain.)

( ) ( ) If you are married, has your spouse submitted an application? If yes, when and where?

Please explain why you have chosen to attend a Via de Cristo weekend.

Note: The “Early Bird” registration (a registration called in or received at least 15 days prior to the Thursday evening check-in) fee is listed below. Please add $20 to the fee if registering within two weeks of the Thursday evening check-in.

Cost for the Fall or Spring weekend at Lake Bloomington’s East Bay Camp is $125.

Checks can be sent with the registration form or payment (check or cash) can be made at the Thursday evening check-in. Please make checks payable to: Heart of Illinois Via de Cristo.

Registrant’s Signature Date

Please have your pastor complete Section II and your sponsor complete Section III on the reverse side. You or your sponsor may return this registration to the address provided at the bottom of Section III.

SECTION II. PASTOR’S SIGNATURE

This member from your congregation is registering to attend an upcoming Heart of Illinois Via de Cristo (Way of Christ). These weekends are designed to provide faith renewal for Christians by grounding them more fully in God’s grace and in the disciplines of prayer, study, and service. It is our hope that participants in the weekend will return to their home parishes renewed and better equipped to serve their church. Therefore, we expect participants in the weekend to be active members of their church. Via de Cristo is designed to strengthen faith rather than provide spiritual conversions for a struggling Christian.

It is our hope that married persons will be able to attend consecutive weekends so that they can share the experience together. If one partner is unable to do this, but could attend at a later date; we encourage the couple to wait. If one partner simply does not want to attend a weekend and is unlikely to ever do so in the future, then we wish to know whether or not you, as their pastor, have any concerns about the impact of the weekend on their marriage.

If you do not have any concerns about your parishioner’s involvement in this weekend, we ask for your signature of support. If you have any apprehension, we would appreciate hearing from you in writing. If you wish to talk to a Spiritual Director about Via de Cristo, please call Pastor David Hofer (217-376-3101 or 217-376-3137) or Pastor Lane Knouse (309-693-0948).

As the registrant’s pastor, I offer my support and prayers for my parishioner’s participation in this opportunity for growth as a Christian leader.

Pastor’s signature

Date

SECTION III. SPONSOR INFORMATION (Please print and fill in completely)

Sponsor’s Name		Weekend attended—when and where			Home Phone
Sponsor’s Address	City			State		Zip
Name and Denomination of Sponsor’s Church			How long have you known the registrant?		Work Phone

Sponsoring a participant is both a joy and a responsibility. The Via de Cristo is not structured to solve a person’s deep-seated personal problems. It is designed to provide to those attending, a deeper understanding of what it means to be a disciple of Jesus Christ. This weekend is intended for baptized Christians, 21 years of age or older. Please select participants with this in mind.
Sponsor’s Signature	Date
This registration form must be completed and returned to: RICHARD AND JILL KEEL, PRE-WEEKEND CHAIRPERSONS, HEART OF ILLINOS VIA DE CRISTO, 1619 SUMMIT DR, PEKIN, IL 61554. Please call Richard and Jill (309-346-6165) if this form is sent within two weeks of the weekend. Thank you.

For additional information concerning the Heart of Illinois Via de Cristo weekends, please visit the HOI VdC web site:

www.heartofillinoisviadecristo.org

Revised July 2007