Search Retreat Signup
January 19-21, 2018
Camp Wesley Pines, Gallman, MS
**THIS FORM IS FOR FIRST TIME RETREAT YOUTH ONLY**
Cost $120 (scholarships may be available as needed if cost is a concern)
Parental Youth Consent forms are available at http://www.jacksonsearch.com/forms
(your parents may have already filled these out with your local parish)
First Name *
Your answer
Last Name *
Your answer
What is the Full Name you would like printed on your name badge? *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Street Address *
Your answer
City *
Your answer
State
Zip Code *
Your answer
Male/Female *
Grade *
High School *
Your answer
Parish, Town *
Age *
Birthday *
for example: 12/5/1990
Your answer
Parent Names *
For example, John and Lisa Smith
Your answer
Parent Mailing Address *
for example: same as above or list addresses if necessary
Your answer
Parent Email Address *
Your answer
Parent Phone Number *
Your answer
TShirt Size *
Have you ever been on a retreat before? *
Favorite color? *
Your answer
What activities are you involved in, what are your hobbies? *
Your answer
Why do you want to attend the Search Retreat? *
Your answer
Any other comments or special needs?
Your answer
Who encouraged you to sign up for the Search Retreat?
Your answer
My Code of Behavior
At all Church sponsored activities, I, along with my peers, represent the Catholic Church. Responsible leadership and character has for so many years been the trademark of Catholic youth within this diocese.

NORMS FOR MY PARTICIPATION...
-I am responsible for my own actions and will be asked to assume the natural consequences for any negative behavior or disturbance. I will take full responsibility for any damage or theft.
-I understand that delegated youth/adult leaders will be enforcing the Code of Behavior.
-I am expected to attend all Search activities on time. A name badge, when provided, will be worn at all times
-I will get a good night’s rest at overnight Searches and agree to any curfew set by Search staff. No visiting is allowed after curfew. Curfew means shut eye time.
-I cannot leave the Search retreat area until the retreat is complete.
-Positively no alcoholic beverages or illegal drugs are allowed.
-Christ-like behavior is promoted and expected at all times. Therefore, inappropriate contact, touch, gesture, language or activity of a sexual nature, is unacceptable.
-No smoking is allowed during any of the Search activities.
-Local or long distance calls that are absolutely necessary will be made at my expense.

The important thing for me to remember is that I represent the Catholic Church and I am asked to project an image of Christian consideration, sensitivity and respect to all others and to the property around me. Infractions of these rules will result in the Search Staff/or Supervising Adult discussing the infraction with the participant. In the unlikely event that a behavior problem based on the above requires extreme action, it is likely to result in my parents being notified and dismissal from the activity and sent home at my own expense.

I agree to cooperate and have no trouble adhering to this simple “Code of Behavior.” *
Note: Your registration is not complete yet
We will mail you a packet that must be filled out and returned 3-4 weeks before the retreat.
Press the submit button below to submit your form.
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