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Wired for Heaven 2026 Incoming 9th Grade Retreat Registration
How to Navigate High School to get to Heaven with St. Carlo Acutis | Marian University | Stayer Center | Wednesday, July 15th | 9:00am - 5:00pm |
REGISTRATION INFORMATION
Student Information
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student's email address:
*
What Parish do you belong to?
*
What High School will your child be attending?
*
PARENT & EMERGENCY INFORMATION
Primary Contact for Communication
*
Last Name
First Name
Email Address
*
This email address will be used for communication from Holy Family. Please make sure to share this information with your student.
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact (different than the primary contact)
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Retreat Information:
Photo Permissions
The Holy Family Parish photographer or coordinator will be present to take photos or videos of the students for use in program displays, the parish bulletin or website, or other publicity-related publications. These materials will only be used for appropriate purposes and names will not be listed. It will be assumed that you give permission for your child to be photographed or videotaped unless you provide a statement via e-mail to Angie Bestul at angieb@hffdl.org. She will reply back to verify that your wishes are understood. If you do not receive a response back within 24 hours, she did not receive your e-mail so please try again.
Parent/Guardian Signature
The individual signing below is certifying that all the information entered above is accurate plus gives Holy Family permission to respond in case of an emergency; including administering any medication listed above or transporting to a hospital, if necessary. If there are any questions, please contact the High School Coordinator.
Signature of Parent/Legal Guardian
*
I certify that I have read the above all this information is true.
Type Parent Name
*
Questions or Comments:
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Should be Empty: