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 Our Lady of Pilar Corpus Christi, TX March 16, 2019 St. George George West, TX March 30, 2019 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 2 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 March 16 th retreat is Friday, March 8 th. The deadline for the March 30 th retreat is Friday, March 22 nd 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 email 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.
2019 Diocesan High School Confirmation Retreat Participant Information Sheet Retreat 1 Our Lady of Pilar Corpus Christi, TX Address: 1101 Bloomington, Corpus Christi, TX 78416 Parish Hall Retreat : March 16, 2019 Registration Deadline: March 8, 2019 Retreat 2 St. George George West, TX Address: 304 Crockett St., George West, TX 78022 Parish Hall Retreat : March 30, 2019 Registration Deadline: March 22, 2019 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.
Diocesan Confirmation Retreat Who do people say that I am? Mark 8:27 March 16, 2019 Parish Group Registration Form Our Lady of Pilar 1101 Bloomington, Corpus Christi, TX, 78416 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) Email: Address: City: Zip: Candidate Name Age/Grade Candidate 1. 1. Sponsor s Name 2. 2. 3. 3. 4. 4. 5. 5. 6. 6. 7. 7. 8. 8. 9. 9. 10. 10. 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 / PO Box 2620 / Corpus Christi, TX 78403 Phone: 361-882-6191 Email: YouthOffice@diocesecc.org Website: www.diocesecc.org/confirmation Registration Deadline for March 16 th Retreat: Friday, March 8, 2019, 5:00pm Sponsors or Proxy are required to attend the retreat with the Confirmation Candidate Late registrations will not be accepted
Diocesan Confirmation Retreat Who do people say that I am? Mark 8:27 March 30, 2019 Parish Group Registration Form St. George 304 Crockett St., George West, TX 78022 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) Email: Address: City: Zip: Candidate Name Age/Grade Candidate 1. 1. Sponsor s Name 2. 2. 3. 3. 4. 4. 5. 5. 6. 6. 7. 7. 8. 8. 9. 9. 10. 10. 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 / PO Box 2620 / Corpus Christi, TX 78403 Phone: 361-882-6191 Email: YouthOffice@diocesecc.org Website: www.diocesecc.org/confirmation Registration Deadline for March 30 th Retreat: Friday, March 22, 2019, 5:00pm Sponsors or Proxy are required to attend the retreat with the Confirmation Candidate Late registrations will not be accepted
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 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 Our Lady of Pilar, Corpus Christi, on March 16, 2019 and at St. George, George West on March 30, 2019.. 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) Signature (Participant 18 years of age or older must sign own consent)
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.) 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 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)
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 (s) of Event: March 16, 2019 and March 30, 2019 Location of Event: Our Lady of Pilar, Corpus Christi and St. George, George West 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) () 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 #: