Luke 18 TEAM - 2022 Registration

Registration Type

Parent/Guardian Information

Parent/Guardian

Relationship to Child/Participant

Parent/Guardian Email

Parent/Guardian Phone
Please provide best number for parent/guardian as listed above.

High School Teen/ College Information

Name

Sex

Male Female

Teen Cell Phone

Teen Email

Address

Teen's Home Parish

Where do you go to School?

T-Shirt Size

Please List any Allergies, required medications, dietary requirements, or any notable medical history. (If you have severe allergies, please include your allergist's contact info)

Pediatrician Name:

Pediatrician Phone #

Health Insurance Provider

Health Insurance Policy #:

Teen/Parent Agreements:

I hereby authorize my son/daughter to be a member of the St. Catherine Laboure Luke 18 team. I understand that Luke 18 participation requires a commitment to the full weekend experience and leaving for other activities is prohibited. I understand that my son/daughter will be offered the opportunity to participate in various activities throughout the weekend. It is understood that all possible caution will be taken by those persons in charge to keep everyone safe and to prevent injuries, but neither the chaperones, the young adult leaders or teens, parishioners, nor St. Catherine Laboure will be held responsible in the case of an accident or injury. I understand that if my teen/young adult behaves in a manner that is deemed inappropriate, is continually disruptive or is found with illegal drugs or alcohol, I will be called immediately to pick up my youth from the activity site.

I hereby authorize any adult chaperone to consent to any medical treatment of the above named youth, which, in the judgment of a recognized medical facility, under the general or special supervision of a licensed physician, may be deemed necessary.

Parent or Guardian Signature:
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Page Break

COMMITMENT CONTRACT

Note: The following dates are if we go with Sunday's for meeting days. If we have to move to Wednesday's these dates will be resent.

Corinthian (Cori) Team Meeting Dates (Freshman, Sophomore)
Please Select any Meetings you will NOT be able to attend. Or Select the last option.

Disciple Meeting Dates (Juniors, Seniors, College)
Please Select any Meetings you will NOT be able to attend. Or select the last option in the list.

Please note any details about your conflicts below:

Random Question

What has been one positive or negative of the pandemic thus far?

Commitment Contract (READ THIS!!!!)

By providing both my signature and my parent's signiture below, I, the high school team applicant, am committing to the following statement:

I am committed to the Luke 18 experience. I have obtained permission from my parents to participate as a team member. I have reviewed my calendar and have prioritized this experience above other conflicting commitments. I realize that being a team member means participation in each of the planning meetings and the retreat itself; as well as being a leader in my words, actions and my faith life. I understand that Luke 18 participation requires a commitment to the full weekend experience and leaving for other activities is prohibited. I will complete tasks on time as I am asked to (i.e.- talk, gifts, ‘L18 homework’ for the week). I recognize that missing meetings may result my removal from the Luke 18 2022 team. I will also take into account the way I live my life on social media and take action to clean up whatever negative portrayals of myself online is necessary to be a better role model and leader for the retreat. I also commit to participating in any activity asked to, even if it goes outside of my comfort zone. I understand that absolutely NO smoking, drugs, alcohol, or profanity is permitted during the preparation and the actual retreat. I recognize that all property at St. Catherine will be respected. Lastly, I understand that the Luke 18 experience is an opportunity for myself and others to grow closer to God. I come with an open heart and mind, and willingness to serve others so that they may have the same opportunity.

Youth Participant Signiture
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Parent or Guardian Signiture
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