Confirmation Retreat Info. What
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- Name of Participant: ______________________________________ T-Shirt Size __________
- Phone :_______________________
- ADD any other medical information concerning medication, allergies, illness, etc.______________________
| Confirmation Retreat Info.
What: The Confirmation Retreat for high school aged teens. A great weekend where we gather in a retreat center, discover our faith and grow in community through fun activities, prayer, discussions, skits and more. Who’s 2nd year Confirmation candidates only. Invited: Parents: Do not sneak a cell phone into your teen’s bag, against the rules of the retreat. This sets a bad example for your teen and helps to spoil the retreat for your teen. If you are concerned about your teen then you may chaperone the retreat. Where: The retreat is being held at Camp Hidden Lake in Dahlonega, GA. The address is: 830 Hidden Lake Rd., Dahlonega, GA 30533 When: Meet at Camp Hidden Lake at 6:30PM on Friday, Feb 17th. Pick up your teen on Sunday, Feb 19th at 1PM. We will attend Mass at Camp Hidden Lake. How Much: The cost is $130 per person. This includes room, food and retreat supplies. Please make checks out to Good Shepherd. - Early bird registration is $130.00 and due Jan 29th - Late registration is $145.00 after Jan 29th What to Bring:
What NOT to Bring: Electronics, IPods, cell phones, etc. If you do, these will be taken away for the retreat. Parents, if you need to get in contact with your teen during the retreat, then I will have my cell phone available the entire weekend. The teens do not need theirs. Even if your child promises not to use the phone except to call his/her parents during free time he/she is still not allowed to bring a cell phone. For more info please contact: Michael Gagnon 470-695-7734 or via email at mgagnon@gsrcc.net. Emergency Contact Numbers Michael Gagnon Camp Hidden Lake 770-344-9004 706-867-0592 Catholic Archdiocese of Atlanta (Church of the Good Shepherd) Confirmation Retreat Feb 17th - 19th, 2017 Parental / Guardian Consent Form and Liability Wavier DO NOT BRING ANY CELL PHONES, MP3 PLAYERS OR OTHER ELECTRONICS. IF YOU DO, THEY WILL BE TAKEN AWAY AND IF THEY ARE STOLEN, IT IS NOT OUR RESPONSIBILITY. Name of Participant: ______________________________________ T-Shirt Size __________Sex _________ Date of Birth________________ Age ____________ Height _______Parent / Guardian's Names: ____________________________________________________________ Address: ____________________________________________________________________________________ _________________________________________________________Home phone #:______________________ Work # ________________________ Cell # _______________________________ I, (Parent/Guardian above), grant permission for my child, (Participant above), to participate in this parish event that requires transportation to a location away from the parish site. This activity will take place under the guidance and direction of parish employees and /or volunteers from the parish. A brief description of the activity follows: Type of Event: Confirmation Retreat Destination of Event: Camp Hidden Lake, Dahlonega, GA Individual in Charge: Michael Gagnon Estimated time of Departure and Return: 6:30PM on Feb 17th – 1PM on Feb 19th Mode of transportation to and from event: Parent Responsibility As a parent and / or legal guardian, I remain legally responsible for any personal actions taken by my child. I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend this PARISH (listed above), its officers, directors, and agents and the ARCHDIOCESE OF ATLANTA, Georgia, chaperones, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors and agents, and the Archdiocese of Atlanta, chaperones, or representatives associated with the event for reasonable attorney's fees and expenses arising in connection therewith. I / We hereby grant permission for publication of group (two or more persons) photo taken at youth events. Signature of Parent / Guardian ________________________________ Date ____________________ (Check one of the following:) ___ I am covered by hospitalization and medical insurance under policy #__________________issued by _______________________________________. ___ I do not have medical coverage and assume responsibility for the cost of hospitalization and medical care for my son/daughter. Emergency Information: We hereby give permission to treat my child ________________________ in case of an emergency. Parent/Guardian Name: ________________________________ Contact #s: ________________________ Signature: _______________________________ ________________________
If you do not check any of the drugs listed below, I will be unable to provide them with any medication whatsoever. I hereby grant permission to any staff person to provide the following over-the-counter drugs to my son/daughter if requested by my son/daughter (Circle all that apply:) __Tylenol __ Benadryl __ Advil __ Sudafed __ Midol __ Kaopectate __ Neosporin __ Pepto Bismol __ Ibuprofen ADD any other medical information concerning medication, allergies, illness, etc.____________________________________________________________________________________________________________________________________________________________________________________________________ADD any dietary restrictions: _______________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________
I would like to Chaperone for this event: ___ Yes ___ No I would like to drive for this trip: _____ Yes _____ No I have ______ many seatbelts in my vehicle, including the driver. Directory: avada -> wp-content -> uploads -> 2015 2015 -> Church of the Good Shepherd, Cumming, Georgia Good Shepherd Middle School Hang Out Night April 22, 2017 Download 20.04 Kb. Share with your friends:
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