Boys Discernment Retreat Registration

1
Please select the retreat you are registering for:* This field is required.
The Fire Within—February 21, 2026
2
Name* This field is required.
First Name
Last Name
3
Email* This field is required.
example@example.com
4
Church Parish* This field is required.
5
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Phone Number* This field is required.
Please enter a valid phone number.
7
Date of Birth* This field is required.
Date
Month
Day
Year
8
Are you over 18?* This field is required.
YESNO
9
Parent Contact Information* This field is required.
Parent's Name
Parent's Phone Number
Parent's Email
10
Allergies
11
Emergency Contact Information* This field is required.
Emergency Contact Name
Relationship to Participant
Emergency Contact Phone Number
12
Photo ReleaseI hereby grant permission to the Diocese of Lake Charles Office of Vocations to use photographs and/or video of me/my child taken at this event to publicly promote the Office of Vocations. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
I agree to the terms of the Photo Release
I do not agree to the terms of the Photo Release
13
Contract of Behavior* This field is required.By submitting this form you hereby agree to the following Contract of Behavior. 1)Taking care of the property of the facility being used and paying for any accidental damage to property. 2) All people-participants, adults, speakers, and diocesan staff are to be treated with respect. 3)Maintaining a healthy environment-no mood altering drugs, including alcohol is to be used by anyone, including adults. Prudent precaution will be take to assure that no one has any mood altering drugs in their possession. Possession of alcohol is grounds for dismissal from the retreat. We provide a smoke-free environment. 4) Maintaining a moral atmosphere-At all times, dress, music, dance, language, signs of affection, and tone of voice is to be appropriate.
I agree to the terms of the Contract of Behavior
I do not agree to the terms of the Contract of Behavior
14
Signature* This field is required.I hereby warrant that to the best of my knowledge, myself/my child is in good health and I assume all responsibility for the health of myself/my child. In the event of an emergency I hereby give my permission to transport myself/my child to a hospital for emergency or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. If participant is under 18, parent or legal guardian must sign.
Clear
Should be Empty: