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The Chosen Overnight Retreat

registration for The Chosen overnight retreat- DaTe tBD
- The maximum number of form submissions has been reached. This form is currently not available.
  
  St. John the Evangelist CRUSH Youth Ministry is hosting a free overnight retreat to watch Season 2 of The Chosen at our Parish Center on (dates to be detrermined) beginning at 7:00pm on Friday and finishing at 1:00 pm on Saturday. We have scheduled times for breaks, small group discussions, and other activities in addition to watching the 8 episodes that make up Season 2.
  
  We are asking each participant to bring their own dinner which we can refrigerate until we eat later in the evening. Drinks and snacks will be provided. Also, everyone should bring their own sleeping bag, pillow, and inflatable bed as we will be sleeping in the Parish Center.
  
  All High School incoming Freshmen through Senior year students are welcome, but must be registered by Wednesday, August 2nd.
  
  Student Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent 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.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  List any allergies, medications, medical issues, physical activity limitations that your teen cannot take part in AND/OR any other important information. Please enter valid data.
  
  Current Medications Please enter valid data.
  
  Physician's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physican's Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy in the Name of REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Company REQUIRED Please fill out this field. Please enter valid data.
  
  Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Identification Number REQUIRED Please fill out this field. Please enter valid data.
  
  By checking this box I hereby agree to all of the following statements: Please select this field.
  
  I hereby give permission for my son/daughter, named below, to participate in the overnight retreat at the Parish Center.
  
  I understand that transportation to this event will need to be provided by the parent or other adult to drop off and pick up the retreatant from the Parish Center.
  
  I also understand that my child will be under supervision and that all adult leaders from the Parish will be in full compliance with the requirements and policies of the Archdiocese of Chicago's Office for the Protection of Children and Youth.
  
  I understand that if my child violates any laws regarding possession of alcohol or drugs, or rules governing the event, I will be expected to retrieve my son or daughter from the event as soon as possible.
  
  I hereby release and indemnify ST. JOHN THE EVANGELIST CATHOLIC PARISH and CRUSH Youth Ministry, its staff and its volunteers, and the Catholic Bishop of Chicago, a corporation sole, from any and all liability whatsover.
  
  In the event, I cannot be reached and there is a necessity for immediate examination and/or treatment of my child, I hereby authorize any of the aforesaid personnel to obtain for my child such medical services as are deemed necessary.
  
  I authorize St. John the Evangelist Catholic Church and the Archdiocese of Chicago to use photographs/videos of my teen for productions, publications, website, and Facebook, Twitter, or Instagram.
  
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St. John the Evangelist
Catholic Church and School

Streamwood, IL

The Chosen Overnight Retreat

registration for The Chosen overnight retreat- DaTe tBD