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Confirmation Retreat

- Liturgy & Sacraments

2024 Confirmation Retreat
Sunday, November 10, 2024
8:00am - 8:00pm
Destinations of event:
- St. Bernard Catholic Church, 2015 Parmenter St, Middleton, WI 53562
- Camp Gray, E10213 Shady Lane Rd, Reedsburg, WI 53959
Individual in charge:
- Geno Finn, Coordinator of Middle and High School Formation
Mode of transportation to and from event: Bus
Cost: $36

You can either pay online or send your payment to St. Bernard. Any checks should be made out to St. Bernard.
Confirmation Retreat
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- 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 REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Biological Sex REQUIRED Please fill out this field.
- Parent/Guardian Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
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- Parent/Guardian Name #1 REQUIRED Please fill out this field. Please enter valid data.
- Phone Number Parent Guardian #1 REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Parent/Guardian Name #2 Please enter valid data.
- Phone Number Parent Guardian #2 Maximum 20 characters Please enter a phone number.
- I grant permission for my child 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 Holy Cross Pastorate employees and/or volunteers from Holy Cross Pastorate.
  I Agree Please select this field.
- As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor (“participant”). I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend Holy Cross Pastorate, its officers, directors, employees and agents, and the Diocese of Madison, Bishop Donald Hying, its employees and agents, chaperones, or representatives associated with the event, from any claim arising from or in connection with my child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate Holy Cross Pastorate, its officers, directors and agents, and the Diocese of Madison, its employees and agents and chaperones, or representatives associated with the event for reasonable attorney’s fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of Holy Cross Pastorate or the Diocese of Madison.
  I Agree Please select this field.
- MEDICAL MATTERS:
- I hereby warrant that to the best of my knowledge, my child is in good health and I assume all responsibility for the health of my child.
  I Agree Please select this field.
- Emergency Medical Treatment: In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, use the Emergency Contact, in the event that both parents/guardians have already been contacted.
  I Agree Please select this field.
- Emergency Contact Name & Relationship REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Family Doctor Please enter valid data.
- Allergies
- Dietary/Food Needs
- Physical Limitations
- Please share other medical or behavioral information that would be helpful for the adult leaders to confidentially know about your child:
- Payment
  The retreat cost is $36. This includes a light breakfast, lunch, and dinner as well as the bus. You can pay online or in person. Any checks should be made out to St. Bernard.
- Retreat Cost36.0
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