2017-18 Kairos Application
Please fill out all required information to register for your Kairos retreat experience for the 2017-18 school year. If you have any questions, please see Mr. Bergen or Mr. Schmitz. Once you have registered, if you need to change any part of your registration, don't resubmit the form - just contact Mr. Bergen. This is for the class of 2018 only; anyone in 2019 who is interested should contact Mr. Bergen or Mr. Schmitz to let them know.
Student Last Name
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Student's First Name
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Please select your first choice.
Student Cell Number
(xxx) xxx-xxxx
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Student Email Address
Input whatever address you check most reliably
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Student Street Address
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Student City
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Student State
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Student Zip
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Please list any food allergies or special dietary considerations
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Parent/Guardian 1 Name (First and Last)
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Parent/Guardian 1 Cell Number
(xxx) xxx-xxxx
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Parent/Guardian 1 Email Address
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Parent/Guardian 2 Name (First and Last)
Your answer
Parent/Guardian 2 Cell Number
(xxx) xxx-xxxx
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Parent/Guardian 2 Email Address
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Primary languages spoken by parents
Should our communications with parents be in some other language than English?
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Cancellation Fee
There is no charge to attend a Kairos retreat. However, any student who registers and then withdraws from a Kairos retreat within 21 days of departure date for reasons other than health or severe family emergency will subject their family to a cancellation fee of $300, to help cover the costs already paid by the school.
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