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 Family Retreat at Mary Queen Catholic Church on March 4th, 2023 from 10am-5pm, 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.

Cost: 

-Early bird registration: $30 per person or $120 max per family

-After January 15th: $40 per person

*Registration will not be complete until payment is received. 

Click Submit to proceed to payment.