ST. THOMAS MORE

CATHOLIC CHURCH

"A Family of Families"

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Confirmation Retreat 2022

- Faith Formation
Contact Us
- Leanne Rodriguez
  
  Youth Minister
  
  713-729-3435 x270
  lrodriguezstmhouston.org

REGISTRATION CLOSES JANUARY 13, 2022.

We are excited to announce that this year as part of our Confirmation program we will be going to Camp Kappe for our Confirmation retreat! This will be held Saturday January 21st-23rd, 2022. Please mark your calendars!

**This will be required for all teens who are enrolled in the Confirmation program 2021-2022 and who wish to be Confirmed 2022. This will be a wonderful experience to get away, grow in deeper relationship with each other, and learn more about what our mission here on earth is and how we are meant to live this mission out in our daily lives.

**In the case of an emergency or if you are sick at the time of the retreat please contact Leanne Rodriguez at lrodriguez@stmhouston.org.
Confirmation Retreat Registration
The maximum number of form submissions has been reached. This form is currently not available.
- Parent/Guardian 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Other Phone Number Maximum 20 characters Please enter a phone number.
- Are you a registered parishioner? REQUIRED Please fill out this field.
- Relationship to Child(ren) REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Parent/Guardian 2
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Address Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Cell Phone Number Maximum 20 characters Please enter a phone number.
- Other Phone Number Maximum 20 characters Please enter a phone number.
- Are You A Registered Parishioner?
- Relationship to Child(ren) REQUIRED Please fill out this field. Please enter valid data.
- Email Please enter an email address.
- Preferred Email for Correspondence REQUIRED Please fill out this field. Please enter an email address.
- Emergency Contact
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Children REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth (xx/xx/xxxx) REQUIRED Please fill out this field. Please enter a date.
  
  Sex as indicated on birth certificate REQUIRED Please fill out this field.
  
  Does your child go to a Catholic School? REQUIRED Yes No Please fill out this field.
  
  If yes, where do they attend? Please enter valid data.
  
  Grade Level in Fall 2021 REQUIRED Please fill out this field.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth (xx/xx/xxxx) REQUIRED Please fill out this field. Please enter a date.
  
  Sex as indicated on birth certificate REQUIRED Please fill out this field.
  
  Does your child go to a Catholic School? REQUIRED Yes No Please fill out this field.
  
  If yes, where do they attend? Please enter valid data.
  
  Grade Level in Fall 2021 REQUIRED Please fill out this field.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth (xx/xx/xxxx) REQUIRED Please fill out this field. Please enter a date.
  
  Sex as indicated on birth certificate REQUIRED Please fill out this field.
  
  Does your child go to a Catholic School? REQUIRED Yes No Please fill out this field.
  
  If yes, where do they attend? Please enter valid data.
  
  Grade Level in Fall 2021 REQUIRED Please fill out this field.
- Who is allowed to drop off/pick up the child(ren) before and after the retreat? REQUIRED Please fill out this field.
- NOTE: If someone tries to pick up the child and is not on this list we will not release child to said person. We will notify you and ask for your permission before releasing the child to anyone not included on this list.
- I understand that if my child will be driving home without adult supervision St. Thomas More is not responsible for my child once the retreat has ended and my child has left the property.
  I Agree Please select this field.
- Doctor's Name REQUIRED Please fill out this field. Please enter valid data.
- Doctor's Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Insurance Name REQUIRED Please fill out this field. Please enter valid data.
- Insurance Group Number REQUIRED Please fill out this field. Please enter valid data.
- Insurance Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Parent/Guardian Electronic Signature REQUIRED Please fill out this field. Please enter valid data.
- Medical Consent
- In the event of an emergency, I hereby give permission to the staff of St. Thomas More Catholic Church to seek emergency medical transport and/or treatment for my child(ren) named above. I will be responsible for all costs incurred. I wish to be advised before further care is given by the hospital or doctor.
  I Agree Please select this field.
- Video/Photography Consent
- As parent/guardian, I understand that promotional pictures and videos ( individual and group) may be taken during the retreat. I give permission for my child(ren)'s pictures (named above) to be used for church promotional materials such as newsletters, web pages, social media such as Facebook and Instagram, calendars, Power Point presentations, or videos to promote or highlight activities of the children in the Confirmation program and retreat experience.
  I Agree Please select this field.
- Consent and Liability Waver
- In the event of any accident or injury, I agree on behalf of myself, my child(ren)'s other parent if known or living, the child(ren) named above or our heirs, successors, and assigns, to hold harmless and defend the Archdiocese of Galveston-Houston, its pastor or any representative of Faith Formation, unless the parties involved were careless and negligent. Effective for all Faith Formation activities at St. Thomas More.
  I Agree Please select this field.
- Accommodations, Support, Health, or Allergy Concerns? REQUIRED Please fill out this field.
- Preferred Parent/Guardian Name for Correspondence REQUIRED Please fill out this field. Please enter valid data.
- I grant permission for my information to be submitted to Flocknote so that the CCE department can communicate with me. I recognize that this is the primary mode through which information regarding CCE will be transmited.
  I Agree Please select this field.
- Your registration will not be complete untill you have paid in full. If you need financial assistance, you can reach the CCE office at 713-729-3435.
- Flat rate per child150.0
- Due Jan 14th ---**NO REFUNDS**
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