Acknowledgement of retreat content *

"This Recovering Couples Anonymous retreat will be focusing on sensitive topics stemming from sexual addiction and betrayal trauma; therefore, for the safety and wellbeing of all participants we ask that at least one member from each couple identify as suffering from a sexual addiction as described in Sex Addicts Anonymous (SAA), Sex and Love Addicts Anonymous (SLAA), Sexual Compulsives Anonymous (SCA), Sexaholics Anonymous (SA), Sexual Recovery Anonymous (SRA), Infidelity Survivors Anonymous (ISA) or KOSA, or some other group focused on helping individuals recover from unwanted sexual behaviors."

We read this and acknowledge the statement above.

Partner 1 - Name *

Please enter your first name and last initial

First Name

Last Name

Partner 1 - Address *

Address 1

Address 2

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Partner 1 Mobile Phone *

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Partner 1 Alternate Phone

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Partner 2 - Name *

Please enter your first name and last intial.

First Name

Last Name

Partner 2 - Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Partner 2 Mobile Phone *

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Partner 2 Alternate Phone

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Are you a first-time couple attendee? *

Yes

No

Would you and your partner like to volunteer for a role at the retreat? *

Click all that apply. Please discuss this with your partner before making a decision.

Presenting - Share your hope, strength, and experience.

IT - Assist with powerpoints, projector, as needed.

Mentor couple during the retreat

Undecided at this time. Please follow up with us.

No, not at this time

By clicking this box, I agree to pay $525.00 to register for the retreat. This pre-registration only holds a temporary place for us at the retreat. Our place at the retreat will not be finalized until payment is received by the committee. *

Yes, I agree

We will be paying the RCA Retreat by the following payment method. *

Please choose one payment type.

Credit Card via Paypal @dbooch8

Zelle (digital payment format) irsan@wt.net