"Outpouring" DOL Confirmation Retreat Jan 30, 2021

Saturday January 30, 9:30 am - 9:00 pm
For those in grades 7-12, cost is $50 per person.

Each participant will need to bring their own lunch, dinner will be provided.

I am registering an individual
Participant's Name

First Name Last Name
Participant's Parish
Parish Confirmation Coordinator
Participant's Age
Participant Gender M/F
Participant Food Allergy/Diet Issues
Parent Name

First Name Last Name
Phone Number

Area Code Phone Number
Email Address
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
This form is being completed by

First Name Last Name
Relationship to teen
Registration Fee
prev next ( X )
I will submit registration fee now using credit card $ 50.00
I will mail a $50 check to St. Francis Retreat Center
St. Francis Retreat Center
703 E. Main Street
DeWitt, MI 48820

I am a parish Confirmation coordinator registering a group
Coordinator Name

First Name Last Name
Email Address
example@example.com
Parish Name
Parish Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Estimated # of male participants
I known, list male participant names
Estimated # of male chaperones
If known, list male chaperone names
Estimated # of female participants
If known, list female participant names
Estimated # of female chaperones
If known list female chaperone names
I understand that my parish is responsible for bringing the appropriate number and gender of chaperones. For those ages 9-14, we must provide 1 for every 8 teens. For ages 15-18, 1 for every 10 teens.
Total due based on estimated number of chaperones and participants:
Full payment is due to St. Francis Retreat Center no later than January 15th.

Make checks payable to St. Francis Retreat Center and mail to:

St. Francis Retreat Center
703 E. Main Street
DeWitt, MI 48820
Should be Empty:

Saturday January 30, 9:30 am - 9:00 pm