2026 - Luke 18 Retreat - Registration Form

Luke 18 Retreat - Registration Form

November 20 (6:00PM) - 22 (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) for questions.
Student Name

First NameLast Name
8th Grader or High School Leader?
PSR? Seton School? Home School? Another Parish?
Student T shirt size
Student Dietary Restrictions
Please write any major medical issues the leadership team needs to be aware of here:
Parent Contact Name

First NameLast Name
Parent Email Address
example@example.com
Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Conflicts?
I hereby grant consent for my child, _______to participate in Luke 18 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.
Signature of Agreement to the statement above.
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

My Products

Luke 18 Retreat Registration - $50

This is the payment fee for the retreat. It will be processed here online through our parish's Stripe account.

$50.00 Quantity

Luke 18 Registration - I will turn in cash/check to the parish office!

by selecting this option, you agree to turn in $50 cash or check written to St. Elizabeth Ann Seton Church to the parish office, clearly labelled with your teen's name.

Free Quantity

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty: