CROSS BAYOU WALK TO EMMAUS

Request for Reservation

Please type or print neatly and fill out all information on this application.
FORM, ALONG WITH PAYMENT IN FULL, MUST BE RETURNED TO YOUR SPONSOR
Walk Requested: 1ST  Choice Date________Walk # ___________ Can you attend on short
2ND Choice Date________Walk # ___________ notice? Yes__ No__
Last Name____________________ First name__________________ Nametag name______________
Address____________________________________ City_________________ St._____ Zip_______
Home phone (___)___________ Business phone (___)____________ Birthdate ________________
Male___ Female___ Married___ Single ___ Divorced ___ Widow(er) _______ # of children________
E-Mail Address _____________________________________________________________________
Present Occupation ___________________________Church now attending______________________

Has the Walk to Emmaus been explained to you, including post Emmaus follow up? _______________
Name, address, phone # of someone to contact in case of emergency ____________________________
and/or who can help us contact you prior to your Walk ______________________________________
                                                                                    ______________________________________
HEALTH RELEASE FORM TO BE COMPLETED BY APPLICANT
Please list all allergies, medications being taken, medical problems, special diets, physical handicaps, or other pertinent information
that may affect your attendance and well being at your Walk to Emmaus weekend.
Explain: ___________________________________________________________________________
__________________________________________________________________________________
In the event of an emergency, and if my closest relative and/or spouse cannot be reached by telephone, the Emmaus staff has my
permission to gain the services of licensed medical professionals to provide the care deemed necessary including anesthesia, for my
well being.
Your signature ________________________________________ Date _________________________
Register ONLY IF YOU INTEND TO BE PRESENT FOR THE ENTIRE WEEKEND. Sponsor should
already have been on a Walk to Emmaus, Cursillo, or Tres Dias.

No reservation will be accepted without the following items:

(1) Completed and signed application, (2) Completed sponsor's form
(3) Payment in FULL ($137) - Make checks payable to Cross Bayou Emmaus Community

REMEMBER: Return your completed, signed application along with payment in full to your Sponsor.

What size T shirt do you prefer? S M L XL XXL XXXL

Your signature___________________________ Your pastor's signature_________________________

Sponsor's signature _______________________Sponsor's name (print or type)___________________

CROSS BAYOU WALK TO EMMAUS

TO BE COMPLETED BY SPONSOR
Sponsoring a candidate is both a joy and a responsibility. There are things you must do for your candidate before, during, and after the weekend Remember also that the Walk to Emmaus is not structured to solve deep-seated personal problems. It is designed to provide, to those attending, a personal encounter with Jesus Christ.
Candidate’s Name ______________________________________________________________________
Your Name _________________________________ Address ___________________________________
City ___________________ State ____ Zip __________ Telephone (H) __________(W) ______________
E Mail Address ________________________________________________________________________
Name/ Denomination of church you attend ____________________________________________________
What Community sponsored your Walk to Emmaus? __________________________ When _____________
Where? ________________________ Walk # ___________ Currently in Reunion Group? ______________
Which group? ______________ Meeting time? ________ Location? _______________________________
Y/N  Has your candidate ever attended a three-day weekend or served on a three-day weekend team?
Y/N  Does your candidate have the physical and mental health needed for a Walk to Emmaus weekend?
Y/N  Is your candidate under any temporary emotional strain? Should his/her weekend be postponed?
Y/N  Will you Pray for your candidate?Will you Bring your candidate to the Walk?
Y/N  Will you Sign up for the prayer vigil?
Y/N  Will you Attend all the weekend community events?
Y/N  Will you Serve and sacrifice for your candidate’s weekend?
Y/N  Will you Help your candidate get into a reunion group?
Y/N  Will you Explain the monthly community gathering to your candidate?
Y/N  Will you Accompany your candidate to the community gathering?
Y/N  Will you Discuss Emmaus with their spouse?
Y/N  Will you Care for their spouse and family during your candidate’s weekend?
Y/N  Will you Maintain minimal contact with your candidate during the weekend?

CONFIDENTIAL INFORMATION FOR THE LAY AND/OR SPIRITUAL DIRECTOR:
Why did you sponsor this person for a Walk to Emmaus?________________________________ ___________________________________________________________________________
Describe your candidate’s spiritual needs during their Walk: _____________________________ ___________________________________________________________________________
If possible, describe your candidate’s personality, spiritual growth, etc. to assist the team in seating,
room assignment, etc ___________________________________________________

Please indicate the size T-shirt that your pilgrim would wear: S M L XL XXL XXXL
Please attach payment for your pilgrim's weekend: $ 120 + $12 (T-Shirt) + $5 (Name Tag) = $137
Signature: ________________________________________ Date: _______________

Womens Walk mail to: Mens Walk mail to:
Annette Painter Barb Fuller
3359 Cypress Village Drive 3524 Lanell Drive
Benton, LA 71006 - (318) 965-3142 Bossier City, LA 71112 (318) 742-2423 / 429-2337