2020-21 Youth Confirmation Retreat Registration

- Faith Formation

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- 2021 Confirmation Retreat
  When:
  Saturday, March 6, 2021 - 9:00 AM to 9:00 PM
  
  Where:
  Mary Queen
  
  Who Can Come?
  The Confirmation Retreat is mandatory for all Confirmation Candidates.
  
  How Much?
  The cost is $150.00 per student, which should be payed in full at the time of registration. The Retreat includes, fun actvities, a t-shirt, breakfast, lunch, dinner, a professional retreat facilitator, special guest speakers and live music.
  
  Additional Info:
  The retreat officially ends at 9:00 PM. Please check your youth out in the Parish Center - Main Hall. This form must be submitted and signed electronically by a parent/guardian in order for a student to attend.
- Parents/Guardians
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Cell Phone Number (xxx-xxx-xxxx) REQUIRED Please fill out this field. Please enter a phone number.
  
  Additional Phone Number Please enter a phone number.
  
  Preferred Email for Correspondence REQUIRED Please fill out this field. Please enter an email address.
- Number of Candidates to be Registered REQUIRED Please fill out this field.
  
  Candidate 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Candidate Email REQUIRED Please fill out this field. Please enter an email address.
  
  Candidate Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Are there any accommodations we need to be aware of (medical, cognitive, developmental, emotional, physical) that will impact your child's ability to learn or participate in classroom activities? If yes, please list. If no, please write None in the box below.
  
  Special Accommodations, Support, Medical/Health or Allergies REQUIRED Please fill out this field.
  
  Candidate 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Candidate Email REQUIRED Please fill out this field. Please enter an email address.
  
  Candidate Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Are there any accommodations we need to be aware of (medical, cognitive, developmental, emotional, physical) that will impact your child's ability to learn or participate in classroom activities? If yes, please list. If no, please write None in the box below.
  
  Special Accommodations, Support, Medical/Health or Allergies REQUIRED Please fill out this field.
  
  Candidate 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Candidate Email REQUIRED Please fill out this field. Please enter an email address.
  
  Candidate Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Are there any accommodations we need to be aware of (medical, cognitive, developmental, emotional, physical) that will impact your child's ability to learn or participate in classroom activities? If yes, please list. If no, please write None in the box below.
  
  Special Accommodations, Support, Medical/Health or Allergies REQUIRED Please fill out this field.
  
  Candidate 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Candidate Email REQUIRED Please fill out this field. Please enter an email address.
  
  Candidate Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Are there any accommodations we need to be aware of (medical, cognitive, developmental, emotional, physical) that will impact your child's ability to learn or participate in classroom activities? If yes, please list. If no, please write None in the box below.
  
  Special Accommodations, Support, Medical/Health or Allergies REQUIRED Please fill out this field.
- Medical Consent/Liability Waiver
  In the event of an emergency, I hereby give permission to the staff of Mary Queen Catholic Church to seek emergency medical transport or treatment for my child(ren) named above. I wish to be advised before further care is given by the hospital or doctor and I understand that all financial obligations are my responsibility. If I cannot be reached please contact the person listed above.
  
  In consideration of my child's participation in Faith Formation, I agree on behalf of myself, my child(ren) named above, and our heirs, successors, and assigns, to indemnify, hold harmless and defend the Daniel Cardinal DiNardo, Archdiocese of Galveston-Houston, Mary Queen Catholic church, its pastor or any representative of Faith Formation or Yourth Ministry (collectively the "indemnitees") from any and all injuries, losses or claims arising out of my child's participation in the program. I further agree that if anyone on my child's behalf makes a claim against the indemnitees, I will indemnify, save, and hold harmless each of the indemnitees from any litigation, expenses, attorney fees, loss, liability, damage or cost which may incur as a result of such claim.
- Medical/Liability Waiver REQUIRED Please fill out this field.
- I give my child(ren) permission to attend the Mary Queen Confirmation Retreat on Saturday, March 6, 2021 at Mary Queen Church in Friendswood, Texas. I understand and I accept full responsibility for my chid(ren)'s actions. I also give my permission for medical care if necessary for my son/daughter.
  
  I understand that all payments made are non-refundable.
- Electronic Signature REQUIRED Please fill out this field. Please enter valid data.
- Cost of Retreat per Student150.0
Total:

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