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Luke 18 8th grade registration form
Luke 18 is January 12-14, 2018, at St. Clare School.

Please fill out this registration form for 8th grade students to participate in the Luke 18 retreat. Please complete the online form and print page 2.Please read carefully.

Fill out the page you print (page 2) and submit with the $50 fee to the St. Clare Parish Office by November 13, 2017. The fee increases to $90 for registrations after November 13 and no late registrations will be accepted after December 11, 2017.
Address: 1411 Cross St., O'Fallon, IL 62269 Attn: Luke 18
Please make check payable to St. Clare Parish (Luke 18).
*Required

Please note: At the end of this online application form, you will need to print the last page and press the submit button in order for your registration information to be recorded.

Student Information
Student's last name *
Your answer
Student's first name *
Your answer
Nickname for name tag (if different than first name)
Example: Matt for Matthew or C.J. for Charles James
Your answer
Street address *
Your answer
City *
Your answer
Zip code *
Your answer
Student's email address *
Your answer
Student's phone number *
Your answer
Birthdate *
Your answer
Age *
Your answer
Gender *
T-shirt size *
Adult sizes
Parish *
Father's first and last name *
Your answer
Father's phone number *
xxx-xxx-xxxx
Your answer
Father's email address *
Your answer
Mother's first and last name *
Your answer
Mother's phone number *
xxx-xxx-xxxx
Your answer
Mother's email address *
Your answer
Medical consideration/allergies (please explain) *
Your answer
Food allergies *
Your answer
Emergency contact *
Name of parent or other contact
Your answer
Emergency contact primary phone number *
xxx-xxx-xxxx
Your answer
Emergency contact secondary phone number *
xxx-xxx-xxxx
Your answer
For sleephouse arrangements, please list at least one friend (another 8th grader attending) your daughter/son would like to be with *
Your answer
Parent volunteer section
Please consider offering to help make this weekend a big success.
I would be happy to have a sleep group at my house *
Mark only one oval.
If a sleep house, list any types of pets in your home
Your answer
I can provide transportation for a group from St. Clare School to a sleep house and back. *
10:30 p.m. Friday and Saturday; 7:30 a.m. Saturday and Sunday
If providing transportation to/from a sleep house, please list the number of students you can transport
Your answer
I would be happy to bring food to share *
Examples: desserts, chips, cookies, rolls, meat dishes
I would be able to work a shift in the kitchen, if needed *
I have completed the Belleville Diocese Child Protection certification and training *
Press submit button after printing the second page
Your registration is not complete until you print the last page and press the submit button.
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