Spring Retreat 2026 - Registration Form
February 20 - 22 @ Lifeteen Camp Cana (near St. Genevieve). This overnight retreat cost is $175 per student (this covers: crewneck sweatshirt, meals and lodging for the weekend). Grades 8-12 welcome! The theme of the retreat is "The Way, The Truth, The Life" Contact youthministry@setonscene.org (Danielle Farley 636-698-4271) for questions.
Student Name
First Name
Last Name
Student current Grade
8th Grade
Freshman
Sophomore
Junior
Senior
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:
Please write down any medication the teen will be taking during the retreat weekend - dosage and name of medication and frequency!
Parent Contact Name
First Name
Last Name
Parent Email Address
example@example.com
Parent Phone Number
Please enter a valid phone number.
Please UPLOAD a copy of your child's insurance card (in case of emergency)
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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 short amount of time from the retreat. (I will coordinate pickups/drop offs with Danielle Farley in advance).
I hereby grant consent for my child, _______to participate in Spring Retreat 2026 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.
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Spring Retreat Registration - pay online
The cost of registration for Spring Retreat. Covers Crewneck sweatshirt, lodging, and meals
$
175.00
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Spring Retreat Registration - cash or check
I will turn in a $175 cash or check written to St. Elizabeth Ann Seton Church (IMPACT in the memo line)
$
Free
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Credit Card Details
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Last Name
Credit Card Number
Security Code
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