St. Mary's Teen Retreat Registration
*SUNDAY, APRIL 22, 2018 (2-6pm) followed by pizza.
*Open to all teens in 8th-12th grade.
*Satisfies the required Confirmation retreat, for those preparing for the sacrament.
Name of Student Attending: (First and Last) *
Your answer
Student's Age: *
Your answer
Student's Grade Level: *
Your answer
Regarding Confirmation: (choose one) *
Parent(s) Name: (First & Last) *
Your answer
Parent Primary Telephone: *
Your answer
Parent Primary Email Address: *
Your answer
Home Parish: *
Your answer
Will your child be staying for pizza after the retreat? (beginning at 6pm) *
Does your child have any dietary restrictions? (If yes, please specify.) *
Your answer
Emergency Contact Name: (other than parent) *
Your answer
Emergency Contact Primary Phone # *
Your answer
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