DIOCESE OF CORPUS CHRISTI
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1 Office of Youth Ministry DIOCESE OF CORPUS CHRISTI 620 Lipan St. Corpus Christi, Texas (361) Fax (361) DIOCESAN CONFIRMATION RETREATS Sts. Cyril & Methodius Corpus Christi, TX February 17, 2018 St. Thomas Aquinas Newman Center at Texas A&M Kingsville Kingsville, TX March 3, 2018 St. Peter, Prince of the Apostles, Corpus Christi, TX March 17, 2018 Sacred Heart Mathis, TX March 24, 2018 Every year, the Office of Youth Ministry sponsors Diocesan High School Confirmation Retreats for those parishes that are unable to conduct their own retreat or for those candidates that were unable to attend their parish confirmation retreat. This year we will be sponsoring 4 separate day retreats, which candidates and their sponsors may choose from. The group registration form must be completed by the Pastor, Director of Religious Education, or Youth Minister of the parish. The total cost of the day retreat is $60 combined for both the candidate and sponsor together. This is to cover the retreat expenses including a hot lunch. The deadline for the February 17 th retreat is Friday, February 9 th. The deadline for the March 3 rd retreat is Friday, February 23 rd. The deadline for the March 17 th retreat is Friday, March 9 th. The deadline for the March 24 th retreat is Friday, March 16 th. Each retreat will have a maximum capacity. Your spot will be reserved once we have received a paid completed registration. Late registrations or walk-ins will not be accepted. Check the website for retreat availability. There will not be payment transfers for anyone that misses their retreat date. You will need to repay for the next retreat. Consent and liability forms will also be required to participate in the Diocesan Confirmation Retreat. There is an Adult Participation form that must be completed by the sponsor or proxy that is attending with the confirmation candidate. Sponsors are required to attend the retreat with their candidate. If a sponsor can t attend, a proxy must attend (such as a parent or guardian). For more information Heath Garcia at YouthOffice@diocesecc.org. *Misspelled certificates will be replaced for free only if the Youth Office is at fault. There will be a $5 charge for all other reprinted certificates.
2 2018 Diocesan High School Confirmation Retreat Participant Information Sheet Retreat 1 Sts. Cyril & Methodius Corpus Christi, TX Address: 3210 South Padre Island Drive Corpus Christi, TX Youth Center Retreat Date: February 17, 2018 Registration Deadline: February 9, 2018 Retreat 2 St. Thomas Aquinas Newman Center at Texas A&M Kingsville Kingsville, TX Address: 1457 Retama, Kingsville, TX Retreat Date: March 3, 2018 Registration Deadline: February 23, 2018 Retreat 3 St. Peter, Prince of the Apostles Corpus Christi, TX Address: 3901 Violet Road, Corpus Christi, TX, St. Mathew Hall Retreat Date: March 17, 2018 Registration Deadline: March 9, 2018 Retreat 4 Sacred Heart Mathis, TX Address: 217 W. San Patricio Ave, Mathis, TX, Parish Hall Retreat Date: March 24, 2018 Registration Deadline: March 16, 2018 The Following information applies to all retreat dates. Check-in begins at 8:00 am; Retreat is from 8:30am 3:00 pm. All participants need to register through their parish; Do not register through the Diocese. To verify the completion of your retreat registration, contact your parish Director of Religious Education/Confirmation Coordinator. This retreat is only for second year Confirmation candidates. For any information regarding the retreat contact your local parish Director of Religious Education/Confirmation Coordinator; Do not contact the retreat location or Diocese. An adult sponsor/proxy is required to attend the retreat with the Confirmation Candidate. The adult sponsor/proxy that attends the retreat needs to have submitted a liability form. Walk-ins will not be accepted. Participants that show up late will not be admitted into the retreat. Participants that leave the retreat early will not receive a certificate for the retreat. Misspelled certificates will be replaced for free only if the Youth Office is at fault; there will be a $5 charge for all other reprinted certificates. All retreat payments need to be submitted to your parish and need to be paid by the retreat registration deadline. If a participant misses their scheduled retreat date they will need to register and repay for another available retreat date; Retreat fees will not transfer. Confessions and Mass will not be offered at this retreat. The Youth Office Bookstore will be available for purchases at every retreat.
3 Diocesan Confirmation Retreat I have called you by name. Isaiah 43:1 February 17, 2018 Parish Group Registration Form Sts. Cyril & Methodius 3210 South Padre Island Drive Corpus Christi, TX Youth Center Check-in begins at 8:00 am; Retreat is 8:30am 3:00 pm Open to Confirmation Candidates & their Sponsors Parish: City: Adult Leader: Phone: (hm / wk / cell) Alt. Phone: (hm / wk / cell) Address: City: Zip: Candidate Name Age/Grade Candidate Sponsor s Name Each candidate s & Sponsor s cost is $30 each, which includes a hot lunch, snacks, and retreat expenses Total Fees Submitted in this Packet Please return form with a single check payable to Diocese of Corpus Christi : Youth Office / 620 Lipan St. / Corpus Christi, TX Phone: YouthOffice@diocesecc.org Website: Registration Deadline for February 17 th Retreat: Friday, February 9, 2018, 5:00pm Sponsors are required to attend the retreat with the Confirmation Candidate Late registrations will not be accepted
4 Diocesan Confirmation Retreat I have called you by name. Isaiah 43:1 March 3, 2018 Parish Group Registration Form St. Thomas Aquinas Newman Center 1457 Retama, Kingsville, TX Check-in begins at 8:00 am; Retreat is 8:30am 3:00 pm Open to Confirmation Candidates & their Sponsors Parish: City: Adult Leader: Phone: (hm / wk / cell) Alt. Phone: (hm / wk / cell) Address: City: Zip: Candidate Name Age/Grade Candidate Sponsor s Name Each candidate s & Sponsor s cost is $30 each, which includes a hot lunch, snacks, and retreat expenses Total Fees Submitted in this Packet Please return form with a single check payable to Diocese of Corpus Christi : Youth Office / 620 Lipan St. / Corpus Christi, TX Phone: YouthOffice@diocesecc.org Website: Registration Deadline for March 3 rd Retreat: Friday, February 23, 2018, 5:00pm Sponsors are required to attend the retreat with the Confirmation Candidate Late registrations will not be accepted
5 Diocesan Confirmation Retreat I have called you by name. Isaiah 43:1 March 17, 2018 Parish Group Registration Form St. Peter, Prince of the Apostles 3901 Violet Road, Corpus Christi, TX, St. Mathew Hall Check-in begins at 8:00 am; Retreat is 8:30am 3:00 pm Open to Confirmation Candidates & their Sponsors Parish: City: Adult Leader: Phone: (hm / wk / cell) Alt. Phone: (hm / wk / cell) Address: City: Zip: Candidate Name Age/Grade Candidate Sponsor s Name Each candidate s & Sponsor s cost is $30 each, which includes a hot lunch, snacks, and retreat expenses Total Fees Submitted in this Packet Please return form with a single check payable to Diocese of Corpus Christi : Youth Office / 620 Lipan St. / Corpus Christi, TX Phone: YouthOffice@diocesecc.org Website: Registration Deadline for March 17 th Retreat: Friday, March 9, 2018, 5:00pm Sponsors are required to attend the retreat with the Confirmation Candidate Late registrations will not be accepted
6 Diocesan Confirmation Retreat I have called you by name. Isaiah 43:1 March 24, 2018 Parish Group Registration Form Sacred Heart 217 W. San Patricio Ave, Mathis, TX, Parish Hall Check-in begins at 8:00 am; Retreat is 8:30am 3:00 pm Open to Confirmation Candidates & their Sponsors Parish: City: Adult Leader: Phone: (hm / wk / cell) Alt. Phone: (hm / wk / cell) Address: City: Zip: Candidate Name Age/Grade Candidate Sponsor s Name Each candidate s & Sponsor s cost is $30 each, which includes a hot lunch, snacks, and retreat expenses Total Fees Submitted in this Packet Please return form with a single check payable to Diocese of Corpus Christi : Youth Office / 620 Lipan St. / Corpus Christi, TX Phone: YouthOffice@diocesecc.org Website: Registration Deadline for March 24 th Retreat: Friday, March 16, 2018, 5:00pm Sponsors are required to attend the retreat with the Confirmation Candidate Late registrations will not be accepted
7 Diocese of Corpus Christi/ Office of Youth Ministry Parish: Diocesan Confirmation Retreat PARENTAL/GUARDIAN CONSENT, LIABILITY WAIVER AND MEDICAL CONSENT Page 1 of 2 (Youth Consent) Participant s Name Home Address City Parent(s)/Guardian(s) Home Phone ( ) Alternate Phone Number: ( ) Parish or Catholic School Date of Birth Zip Code Cell Phone Grade Age Sex PARTICIPATION CONSENT, LIABILITY WAIVER & PHOTOGRAPHY/VIDEOGRAPHY CONSENT Important! To be filled out by the Parent/Guardian for youth under 18 years of age. If participant is 18 years of age or older, consent must be signed by the individual) I (name of parent/guardian), grant permission for my child, (participant s name), to participate in the Diocesan Confirmation Retreat to be held at February 17, 2018 at Sts. Cyril & Methodius Corpus Christi, March 3, 2018 at St. Thomas Aquinas Newman, March 17, 2018 at St. Peter, Prince of the Apostles Corpus Christi, and March 24, 2018 at Sacred Heart Mathis.. I agree on behalf of myself, my child s other parent if known or living (name of parent), my child named herein, or our heirs, successors, and assigns, to release and hold harmless and defend the Diocese of Corpus Christi, the sponsoring parish (its pastor, youth minister, principal, other agents, etc.) or any representatives associated with the scheduled activity from all damages, claims, suits, expenses and payments for injury to my child and/or property, including all damages, claims, suits, expenses and payments resulting from the negligence of the Diocese of Corpus Christi, and parish, and/or their officers, directors, and employees. As parent/guardian, I understand that promotional pictures (individual and group) will be taken during this event. I give permission for my son s/daughter s picture to be used for promotional materials (newsletter, web page, calendars, power point, video, etc.) in highlighting the event. Signature (Parent/Guardian) Date Signature (Participant 18 years of age or older must sign own consent) Date
8 MEDICAL CONSENT Medical Matters I hereby warrant to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. Of the following statements pertaining to medical matters, sign only those in accordance with your wishes: Emergency Medical Treatment In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency and you are unable to reach me, contact: Name & Relationship Family Doctor Phone Phone Medications: My child will bring all such medications, well labeled, that are necessary. Names of medications and concise directions for seeing that the child takes such medications, including dosage and frequency are as follows: Medication(s): Dosage: Administer: I hereby Do Not Grant Permission for medication of any type, whether prescription or nonprescription may be administered by my child unless the situation is life threatening and emergency treatment is required. (Please initial) I hereby Grant Permission for nonprescription medication (such as Tylenol, throat lozenges, cough syrup) to be given to my child, if deemed advisable. I understand that Aspirin will not be given to my son/daughter. (Please initial) Medical Conditions Information (Diocesan personnel will take reasonable care to see that the following information will be held in confidence.) My son/daughter has had an episode of the following or has been diagno Allergic reactions to the following (foods, dyes, latex etc.) Has had a medical surgery within the last six months? Yes No Still under doctor s care? Yes No Has a medically prescribed diet? The following physical limitations? Immunizations current and up to date: Yes No Date of last tetanus/diphtheria immunization You should also be aware of these special medical conditions of my child: Insurance Information (Please attach a copy of the Insurance Card, front and back, with this form) Insurance Carrier: Name of Insured: Insurance Policy Number: Page 2 of 2 (Youth Consent) Father s Name: Mother s Name: Day Phone: Day Phone: No, I do not carry medical insurance at this time. In the event it comes to the attention of the chaperones associated with the activity that my child becomes ill with repeated symptoms such as headache, vomiting, sore throat, fever, diarrhea, I want to be called immediately. If this will be a long distance call, I want to be called collect (with phone charges reversed to myself). I fully understand the foregoing statements and sign this Parental/Guardian Medical Consent Waiver knowingly, freely, and willingly. Signature (Parent/Guardian) Signature (Participant 18 years of age or older must sign own consent) Date Date
9 Diocese of Corpus Christi and/or Parish of Adult Participant s (Sponsor) Release of Liability and Medical Release Form Name: Parish: Daytime Phone # Address: City: State: Zip: Health Insurance Carrier: Insurance ID Number: Insurance Policy Number: Name of Event: Diocesan Confirmation Retreat Date(s) of Event: Feb. 17, March 3, March 17, March 24, 2018 Location of Event: Sts. Cyril & Methodius, St. Thomas Aquinas Newman, St. Peter, Prince CC, Sacred Heart-Mathis I agree on behalf of myself, my heirs, successors, executors, personal representatives and assign to protect, indemnify, save, and hold harmless the Diocese of Corpus Christi, and parish, and their officers, directors, agents employee, or representatives associated with this event/trip from all damages, claims, suits, expenses and payment on account of or resulting from conditions stated on or resulting from any such injury, death, or damage to property, including resulting from the negligence of the Diocese of Corpus Christi, and parish, and/or their officers, directors, and employees arising from or in connection with my attending youth ministry events. 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 attorneys fees and expenses incurred by the prevailing party. In the event that I should require medical treatment and am not able to communicate my desires to attending physicians or other medical personnel, I give permission for the necessary emergency treatment to be administered. Please advise the doctors that I have the following allergies: (Signature) (Date) In case of an emergency and for permission for treatment beyond emergency procedures, please contact: Emergency Contact Name: Relationship to me: Day Time Phone #: Night Time Phone #:
DIOCESE OF CORPUS CHRISTI
Office of Youth Ministry DIOCESE OF CORPUS CHRISTI PO Box 2620 Corpus Christi, Texas 78403 (361) 882-6191 Fax (361) 693-6787 www.diocesecc.org/youth YouthOffice@diocesecc.org DIOCESAN CONFIRMATION RETREATS
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