Facebook Instagram Flocknote YouTube

Confirmation Retreat

- 2026 Confirmation Retreat Registration Form
  
  This form is not accepting responses at this time.
  
  Retreat Details:
  Friday, February 13th – Sunday, February 15th
  - Retreat starts at 7:30 PM Friday at La Purisima
  - Retreat pick up time is 6:00 PM Sunday after the 5:00 PM Life Teen Mass at St Andrews
  - Cost: $0 but bring a snack to share. All other meals provided
  - Church Emergency POC: Deacon Bill Polakowski 520-266-9393
  
  Parent
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Phone REQUIRED
  
  Please fill out this field. Please enter a phone number.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  Participating Children REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergies or special considerations
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergies or special considerations
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergies or special considerations
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergies or special considerations
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergies or special considerations
  
  Parent Agreement
  
  I, the undersigned, do hereby release, forever discharge, and agree to hold St. Andrew the Apostle, the Diocese of Tucson, and the site organization(s), harmless from any and all liability, claims, demands, lawsuits, and expenses arising from personal injury, sickness, death, or property damage of any nature whatsoever, which may be incurred or suffered by the participant while attending the above activity. Furthermore, I hereby assume all risk of personal injury, sickness, death, damage and expenses arising from the participant’s participation in all activities, including recreation and work activities involved in the above activity. In addition, I authorize and grant permission to furnish all necessary transportation, food, lodging, and medical treatment for the participant. I give permission for diagnoses, treatment, and prescription of medication in accordance with standard medical practice by appropriate health care personnel. I release St. Andrew the Apostle, the Diocese of Tucson, and the site organization of all responsibility and consequences that may arise as a result of any injury suffered and resulting treatment. Further, I agree to accept any and all financial responsibility as a result of scheduling, acquiring and/or providing medical treatment. I further hereby agree to indemnify and hold St. Andrew the Apostle, The Diocese of Tucson, the site organization(s), and their respective members, directors, employees, volunteers, and agents (collectively, the “Indemnitees”), harmless from and against any and all claims, demands, actions, lawsuits, damages and liabilities, including attorneys’ fees and expenses sustained by the Indemnitees as the result of the negligent, willful, or intentional acts of the participant. Furthermore, I understand that St. Andrew the Apostle, the Diocese of Tucson, and the site organization will not be liable if the participant fails to cooperate with the rules and that any infraction of the rules may result in immediate dismissal from the event at my expense. If the participant is now and will be under 18 years of age at the time of the conference: I, the parents or legal guardians, hereby agree to all of the foregoing on behalf of the participant and grant permission for the participant, to fully participate in the above activity and all its undertakings. I also give permission for photographs and videos to be taken for Parish use. Through me, the minor agrees to abide by all the rules and regulations stated by St. Andrew the Apostle, the Diocese of Tucson, the site organization, and the event staff.
  
  I Agree Please select this field.
  
  Additional Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  In case of an emergency or illness and neither parent can be reached, do you authorize the Retreat Director or other Adult Chaperone to act if medical assistance is necessary? REQUIRED Yes No Please fill out this field.
  
  I give permission for photos to be taken that may be used for St. Andrew’s promotional use. REQUIRED Yes No Please fill out this field.
  
  I have read and understand the above information.
  I Agree Please select this field.
  
  Submit