2024 Confirmation Retreat Registration

Registration for November 9-10 Confirmation Retreat.
Please Note:

If your child is a NEW candidate this Fall (i.e., you recently registered them to start Confirmation preparation), they are already signed up to attend retreat and you do not need to complete this form. The retreat registration was built into their registration for Confirmation prep, and the registration fee you paid covers the cost for your child to attend retreat.

If your child is in the 2025 Preparation Group* and still needs to attend Confirmation Retreat before they get Confirmed this January, please proceed to fill out this form so that we know they will be attending. Thanks!

*2025 Preparation Group refers to the candidates who started their preparation last school year and are finishing up preparation this Fall in order to be confirmed in January 2025.

Full details about Confirmation Retreat may be found in the Confirmation Retreat Information Packet.
Student and Parent Information:
Student Name*

First NameLast Name
Gender:*

MaleFemale
Parent Contact Name:*

First NameLast Name
Parent Phone Number*
Parent E-mail Address:*
Medical Form and Release
Please indicate any allergies, medications, special needs, or physical/mental health conditions that we should know about in the fields below. You may leave any fields blank that do not apply to your child:
Dietary Restrictions or Food Allergies
e.g., vegan, gluten free, peanut allergy
Other Allergies:
Medications your child takes:
Medical conditions:
e.g., asthma, type 1 Diabetes, epilepsy
Mental or behavioral health conditions:
e.g., anxiety, bipolar disorder, ADHD
Any special needs (physical, learning, or behavioral) that we should be prepared to accommodate:
Emergency Contact: In case of emergency, we will make multiple attempts to reach the parent listed on this registration form. However, in case we are unable to reach you in an emergency situation, please provide an alternative person and phone number that we can contact.
Emergency Contact*

First NameLast Name
Emergency Contact Phone Number*
Relation to Child*
Emergency Contact Phone Number
Please upload a picture/scan of your Family Insurance Card (front and back)

Cancelof
Medical Release*

Parental Consent to Participate

Your son/daughter is eligible to participate in a parish sponsored activity requiring transportation to a location away from the parish building. This activity will take place under the guidance and supervision of authorized personnel from St. Patrick Catholic Parish. A brief description of the activity is found below.

	Name of Event:	St. Patrick Confirmation Retreat
	Date of Event:	November 9-10, 2023
	Location:	7000 McClements Road, Brighton MI
	Designated Supervisor of Event:	Marissa Dawson
	Method of Transportation to Event:	Parent drop-off/pick-up

If you would like your child to participate in this event, please sign the following statement of consent and acknowledgment. As parent or legal guardian, you remain responsible for any legal responsibility which may result from actions taken by the named student.

Permission to participate.*
Photo Release
Parent Signature*

Clear
Type name of signature here:*

Retreat Payment

The cost of Confirmation Retreat is $150. This covers the cost of facilities rental, meals, and activities.

We never want participation in a retreat to become a financial burden for our families. If you need assistance covering the cost for your child to attend retreat, please select the option to request scholarship funds and we will take care of that for you.

Please make your payment selections below:*

Confirmation Retreat Fee

$150.00

I would like to request scholarship funds to cover my child's retreat fee

$ Free

Payment is not workingIf the payment field is not working or showing an error that prevents you from completing this form, please select this option and we can collect payment later.

$ Free

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Questions/Comments Regarding Payment:
Should be Empty:

2024 Confirmation Retreat Registration

Student and Parent Information:

Medical Form and Release

Parental Consent to Participate

Retreat Payment

Payment Methods