Please Note:

If your child is a NEW candidate this Fall (i.e., you recently registered them to start Confirmation preparation), you do not need to complete this form. You will be asked to register your child for retreat while filling out the New Candidate Intake Form (schedule to be sent to all newly registered families over Labor Day weekend).

If your child is in the 2027 Preparation Group* and still needs to attend Confirmation Retreat before they get Confirmed this January, please proceed to fill out this form so that we know they will be attending. Thanks!

*2027 Preparation Group refers to the candidates who started their preparation last school year and are finishing up preparation this Fall in order to be confirmed in January 2027.

Full details about Confirmation Retreat may be found in the Confirmation Retreat Information Packet.

Student and Parent Information:

Student Name

First NameLast Name

Gender:

Parent Contact Name:

First NameLast Name

Parent Phone Number

Format: (000) 000-0000.

Parent E-mail Address:

Medical Form and Release

Please indicate any allergies, medications, special needs, or physical/mental health conditions that we should know about in the fields below. You may leave any fields blank that do not apply to your child:

Dietary Restrictions or Food Allergies

e.g., vegan, gluten free, peanut allergy

Other Allergies:

Medications your child takes:

Medical conditions:

e.g., asthma, type 1 Diabetes, epilepsy

Mental or behavioral health conditions:

e.g., anxiety, bipolar disorder, ADHD

Any special needs (physical, learning, or behavioral) that we should be prepared to accommodate:

Emergency Contact: In case of emergency, we will make multiple attempts to reach the parent listed on this registration form. However, in case we are unable to reach you in an emergency situation, please provide an alternative person and phone number that we can contact.

Emergency Contact

First NameLast Name

Emergency Contact Phone Number

Format: (000) 000-0000.

Relation to Child

Emergency Contact Phone Number

Format: (000) 000-0000.

Please upload a picture/scan of your Family Insurance Card (front and back)

Medical Release

Parental Consent to Participate

Your son/daughter is eligible to participate in a parish sponsored activity requiring transportation to a location away from the parish building. This activity will take place under the guidance and supervision of authorized personnel from St. Patrick Catholic Parish. A brief description of the activity is found below.

	Name of Event:	St. Patrick Confirmation Retreat
	Date of Event:	November 7-8, 2026
	Location:	7000 McClements Road, Brighton MI
	Designated Supervisor of Event:	Marissa Dawson & Samuel Ekblad
	Method of Transportation to Event:	Parent drop-off/pick-up

If you would like your child to participate in this event, please sign the following statement of consent and acknowledgment. As parent or legal guardian, you remain responsible for any legal responsibility which may result from actions taken by the named student.

Permission to participate.

Photo Release

Parent Signature

Type name of signature here:

Nov. 2026 Confirmation Retreat Registration

Student and Parent Information:

Medical Form and Release

Parental Consent to Participate