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Heritage provides a welcoming Catholic environment that serves local and faith communities through beauty, peace and historical connection

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1 Welcome

2 Dates

3 Price

4 People in your group

Each guest in your party will receive an email to complete their personal information

Guest 1		First Name* Last Name* Email* Gender*
Guest 1		First Name* Last Name* Email* Gender*

After completing this form, emails will be sent to everyone in your group to complete their information.

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5 Additional Information

Title
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Gender *
Diet Details *
Diet Notes
Emergency Contact Info *	Please provide name and phone number
Does your party include children ages 4 and under? *	No Yes Complimentary stay for children ages 4 and under
Please list number of children and ages *
Comments or Special Needs
How did you hear about this?
Reason for Visit	Breakaway from routine Spiritual growth/renewal Individual reflection Spending time with family/friends Time in nature Physical rest Self directed silent retreat
Code of Conduct *	I have read and accept the Code of Conduct belowAll Heritage buildings and grounds are vape-free and smoke-free facilities. All guests are required to maintain a respectful and mindful sound level while on the grounds. Quiet hours are enforced between 9pm and 8am.
Pet Policy *	I have read and accept the pet policy belowAnimals and/or pets are not permitted on Heritage property.
Parking - Daytime *	I have read and accept the parking parameters belowUse of vehicles is restricted to roads and parking areas as marked. Driving is limited within the grounds of Heritage.
Cancellation - Daytime *	I have read and accept the cancellation terms belowRegistration may be cancelled for no charge up to 14 days prior to arrival. Registration is non-refundable if cancelled within 14 days of arrival.
Mission Statement *	I have read and agree with Heritage's Mission Statement belowHeritage provides a welcoming Catholic environment that serves local and faith communities through beauty, peace and historical connection
Media Release *	I have read and agree with the Media Release belowI am aware that by visiting Heritage, I consent to my voice, name, and/or likeness being used, without compensation, in photographs, films and tapes for use in any and all media associated with Heritage.
Release and Waiver of Liability *	I have read and agree with the Release and Waiver of Liability belowI, as a registered guest at Heritage, individually and as the parent or legal guardian of all minor children accompanying me during my stay (each, a “Minor Child”), individually and for my heirs, beneficiaries, next of kin, estate, legal or personal representatives, successors and assigns, hereby release, waive and covenant not to sue Purification Heritage Center, Inc., Purification Properties LLC and The Roman Catholic Archdiocese for Atlanta (and its Archbishop), and each of their respective members, owners, managers, officers, directors, agents, employees, representatives, successors and assignees (all of whom are hereinafter referred to individually and collectively as the “Released Parties”), from and against any and all claims, actions, liability, damages, costs and expenses (including without limitation attorney’s fees) arising from or incurred, directly or indirectly, for personal injury, death or property damage caused to or suffered by any Minor Child, any of my family members or relatives, any other person or entity, or me, arising from, caused by or in any way related to any Minor Child’s or my presence (or participation in any activities undertaken while present) on or use of any real property or personal property belonging to, leased by or under the control or supervision of any of the Released Parties. I, individually and on behalf of my heirs, beneficiaries, next of kin, estate, legal or personal representatives, successors and assigns, also agree that if I make or anyone else makes any claims against any of the Released Parties because of any injury (including death) to any Minor Child or any other person, or for any damage to any Minor Child’s or my property, or the property of any other person, arising from, caused by or in any way related to any Minor Child’s or my presence (or participation in any activities undertaken while present) on or use of any real property or personal property belonging to, leased by or under the control or supervision of any of the Released Parties, I will fully defend, indemnify and hold harmless all of the Released Parties from and against all claims, actions, liability, damages, costs and expenses (including without limitation attorney’s fees) arising from or incurred, directly or indirectly, as a result of any such claim. Further, to the fullest extent allowed by law, I hereby waive any Minor Child’s rights and my rights, individually and as a parent or legal guardian, to sue or to bring claims of any kind against any of the Released Parties, and further covenant not to sue or otherwise bring any such claim or action individually or on behalf of any Minor Child. I acknowledge that there is no particular necessity for any Minor Child or me to participate in any of the activities referenced or described herein, and I myself am undertaking them, and/or am permitting any Minor Child to undertake them, of my own free will and volition. Any such Minor Child and I are bound by this Release and Waiver of Liability, as are the family members, heirs, beneficiaries, next of kin, estate, successors, assigns, legal guardians and personal representatives of such Minor Child or mine. This Release and Waiver of Liability shall be construed under the laws of the State of Georgia.
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1 Welcome

2 Dates

3 Price

4 People in your group

5 Additional Information

6 Payment