Luke 18 Retreat - Registration Form
October 17 (6:30PM) - 19 (12:30PM) on the campus of St. Elizabeth Ann Seton Church & School! Students will be dropped off and picked up each day and will sleep at their own homes. The retreat cost is $50 per student (this covers: Tshirt, most meals/snacks, and several religious gifts). Contact youthministry@setonscene.org (Danielle Farley 636-698-4271) for questions.
Student Name
First Name
Last Name
8th Grader or High School Leader?
I am in 8th Grade
I am a high school leader
PSR? Seton School? Home School? Another Parish?
I'm a student at Seton Regional School
I'm a PSR Student at Seton
I'm a Home School Student
I attend another parish
I am a high school teen leader
Student T shirt size
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Student Dietary Restrictions
Please write any major medical issues the leadership team needs to be aware of here:
Parent Contact Name
First Name
Last Name
Parent Email Address
example@example.com
Parent Phone Number
Please enter a valid phone number.
Conflicts?
My child has NO CONFLICTS and will be present for the entire retreat
My child has a SMALL CONFLICT and will only need to be gone for a couple hours from the retreat. (I will coordinate with Danielle Farley).
My child will miss a major portion of the Luke 18 Retreat and will therefore need to contact the youth minister to arrange another retreat with another parish.
I hereby grant consent for my child, _______to participate in Luke 18 Retreat 2025 with IMPACT Youth Ministry. I understand that this event will take place on the St. Elizabeth Ann Seton church/youth grounds and that my child will be under the supervision of the designated parish employee and other adult volunteers.
*
Yes, I agree to the above statement.
No, I do not agree to the above statement.
Signature of Agreement to the statement above.
Date Signed
-
Month
-
Day
Year
Date
Continue
Continue
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