Luke 18 Registration
Luke 18 is a retreat led by St. Vincent Youth Ministry with the assistance of the High School Leadership Team ("Disciples" - 11th and 12th graders, and "Cori Team" - 10th graders). The goal of this retreat is to introduce 7th, 8th, and 9th grade teens to a personal relationship with God through prayer, personal witness and testimony, praise and worship, and community.

Retreat activities will take place on St. Vincent Parish campus. Retreat participants will stay overnight in St. Vincent High School supervised by adult volunteers.

Name of Event: Luke 18 Retreat
Event Begins: March 19, 2021 in the evening
Event Concludes: March 21, 2021 at noon

Cost: $45.00 for high school leaders (10th, 11th, 12th grade) and $60 for "Lukers" (7th, 8th, and 9th grade) – includes all on-site meals, supplies, and retreat t-shirt. Checks should be made payable to St. Vincent Parish.

* Families of retreat volunteers and participants are invited to the closing prayer service at St. Vincent Church on Sunday at 11:00am

In order to participate in Luke 18 as a high school leader, Luker, or adult volunteer, please complete and submit this form. Applications are still being accepted.


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Type of Registrant *
Name: *
Age *
Grade *
Gender *
School: *
Teen Phone Number: *
Teen Email: *
T-shirt Size *
Special Conditions/ Dietary Needs
Prescription Medications
Is your teenager responsible for taking their own medications?
Clear selection
May we administer nonprescription medication (such as Advil, Benadryl, cough drops) if needed? * *
Home Address *
Parent/Guardian name (first and last):
Parent/guardian phone number *
Parent(s) email: *
Emergency contact name (first and last) - someone in addition to the parent mentioned above. *
Emergency contact phone number: *
Attendance. *
Required
Have you ever participated in a Luke 18 retreat before? *
Short-Answer Questions :Please respond briefly to the following questions. There are no right or wrong answers – these questions simply help us get an idea of where you are in the weeks leading up to this retreat so we can best serve the 8th grade participants at Luke 18.                                                                                                                 Please explain why you want to participate in Luke 18. *                                                                                                                         *
Parental/Guardian and Participant - Liability Waiver, Media and Medical Consent Form and Agreement                           *
1. As the parent or guardian, in signing this form, I hereby state that the information included in this form is correct and give the permission for my child to participate in the activity entitled.                                                                                                                               2. I understand that my child will be under the supervision of North Perry County staff and volunteers.                                                          3. I recognize that there are risks inherent in participation in any activity and agree to hold North Perry County Parishes, its affiliates, and its and their employees, volunteers, and agents, harmless from any injury to my child or damage to or loss of personal property of my child not caused by the negligence or misconduct of North Perry County Parishes, its affiliates and its and their employees, volunteers, and agents.                                                                                                                                                                     4. In the case of a medical emergency, I understand that every effort will be made to contact me, but in the event that I cannot be reached, I hereby give permission for my child to be evaluated, diagnosed, and treated in accordance with standard medical practice by licensed medical personnel.                                                                                                                                                         5. I hereby give permission to North Perry County Parishes to use any photographs or video footage taken of my child in print on their website, Facebook, Instagram, Twitter, emails,  etc.. for promotional purposes.                                                                                                         6. I understand that for all Youth Ministry activities there is a zero tolerance policy for the use of any mood altering chemicals (including alcohol and illegal drugs), foul language, threats, or any type of abuse and inappropriate physical contact. I agree to follow this policy.                                                                                                                                                                                                      
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Parent/Guardian signature: *
Youth signature: *
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