LET'S BRIGHTEN OUR COMMUNITY

LET'S BRIGHTEN OUR COMMUNITY

A SERVICE RETREAT FOR ALL HIGH SCHOOL TEENS. Saturday, January 10 through January 11, 2026. at Camp Zephyr and nearby cities.
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
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Parent/Guardian Phone Number*
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Parish*
Youth Leader*
Parish Name/City
Is there anything we should know in regard to your child participating in this event (exp. Allergies, emotional or physical needs)?*

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Please Explain:
Transportation*

My child will be dropped off and picked up from the eventMy child will be traveling to the event with the parish ministry program. Please Note it is up to the parish ministry program and their leaders to follow correct guidelines for youth transportation within the Diocese of Corpus Christi.
I, grant permission for my child, Child's Name* "Let’s Brighten Our Community,” service retreat on January 10^th, 2026 – January 11^th, 2026, to be held at Camp Zephyr, traveling by charter bus & carpool from Corpus Christi, TX, to Camp Zephyr, Beeville, Alice, Sinton, Mathis and nearby cities and Camp Zephyr in Sandia Texas.
RELEASE, WAIVER AND INDEMNITY AGREEMENT

In consideration of my child’s participation in this diocesan event (Let’s Brighten Our Community a Camp Zephyr in Sandia Texas, and traveling from Corpus Christi, TX. to Camp Zephyr and area cities for service opportunities) , I(name of other parent) agree on behalf of myself, our heirs, successors, executors, personal representatives and assigns to protect, indemnify, save, and hold harmless the Diocese of Corpus Christi, and their officers, directors, agents employee, or representatives associated with these activities mentioned above from all damages, claims, suits, expenses and payment on account of or resulting from any such injury, death, or damage to property, including resulting from the negligence of the Diocese of Corpus Christi, and their officers, directors, and employees arising from or in connection with my son/daughter attending these activities. In the event that any legal action is taken by either party against the other party to enforce any of the terms and conditions of this agreement, it is agreed that the unsuccessful party to such action shall pay to the prevailing party therein all court costs, reasonable attorney’s fees and expenses incurred by the prevailing party.

THE UNDERSIGNED HEREBY PERMITS THE DIOCESE, and media outlets to make and use photographic likeness of my son/daughter, in a still or video commercial, to be exhibited by television broadcasting and/or the internet at the said media outlets. The material will be used for news and/or Diocesan purposes. It will also be utilized in Diocesan print materials and any forms of media release and/or video produced to help the Diocese.

THE UNDERSIGNED further expressly agree(s) that the forgoing RELEASE, WAIVER AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the laws of the State of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. THE UNDERSIGNED HAS (HAVE) READ AND VOLUNTARILY SIGN(S) THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT and further agree(s) that no oral representations, statements or inducement, apart from the foregoing written agreement, have been made.
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Date*

MonthDayYear
Date
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If funds are tight, and you need assistance, reach out to Sr. Caritas at srcaritas@diocesecc.org or 361-631-4386 for an alternative registration form.
Let’s Brighten Our Community Service Retreat*
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FeeLet's Brighten Our Community - Sandia, TX
$25.00 Quantity

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