Kairos Registration
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Student Name: *
Student Email *
Address
City
State
Zip
Parent Email *
2nd Parent Email (important if parents are divorced so all parents get the information)
Student Cell Number *
Parent Cell Number *
Check all non-prescription products that my child may have.
Please list any medical concerns, food allergies or other information that would be helpful for the adults directing the retreat.  
1st Choice: (First day of retreat leaves around 5:00pm and returns the last day of the retreat around 5:30pm) *
Required
2nd Choice: (First day of retreat leaves around 5:00pm and returns the last day of the retreat around 5:30pm) *
Required
3rd Choice: (First day of retreat leaves around 5:00pm and returns the last day of the retreat around 5:30pm) *
Required
Parent PermissionI hereby give my son/daughter permission to participate in the Kairos Retreat Program, coordinated by Saint Thomas Aquinas High School and held at the Savior Pastoral Center in Kansas City, KS. I also give him/her permission to utilize the transportation supplied by Saint Thomas Aquinas to and from the retreat center. I hereby release the Archdiocese of Kansas City in Kansas, Saint Thomas Aquinas and all sponsors, chaperones, aides and others connected from any and all claims arising out of or from any accident or occurrence, causing injury to any person or property, during this event. If a student shares information that they are being injured or could injure themselves or others, the adult team is required to share that information with the appropriate authority, which could include a school counselor, school president, parent(s) or social services. In the event my child is dismissed from this event for any reason, I am responsible for his/her transportation home. I understand my child’s obligation to participate in the retreat from start to finish. I understand all cell phones and electronic devices are prohibited. All bags/suitcases will be available for inspection at arrival of retreat. *
You will be charged after registration through the FACTS. Full payment will be due a week before the retreat.  You can pay gradually up until the due date.  Cost for Kairos retreat is $300.   *
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