Confirmation Retreats

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Student Last Name REQUIRED Please fill out this field. Please enter valid data.
Student First Name REQUIRED Please fill out this field. Please enter valid data.
T-Shirt Size REQUIRED Adult Small Adult Medium Adult Large Adult XL Adult 2X Adult 3X Please fill out this field.
Parent Email REQUIRED Please fill out this field. Please enter an email address.
Emergency Contact Name: 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.
Allergies: REQUIRED Food Medication Other Please fill out this field.
Please list allergens: Please enter valid data.
Medication to be taken during retreat: Please enter valid data.
Other Health Info: Please enter valid data.
I give my son/daughter permission to attend the Youth Ministry event:

Antioch Weekend at OLGC Parish on February 21 & 22, 2026

Furthermore, in the event that my child becomes ill and requires medical attention of any kind, and a family member cannot be reached, I hereby authorize an agent of Our Lady of Good Counsel Parish to make the necessary decisions concerning emergency treatment. I also give permission for my child to be transported to the nearest medical facility or hospital for treatment.
I Agree Please select this field.
Parent Name: REQUIRED Please fill out this field. Please enter valid data.
Retreat Fee REQUIRED
50.0 – First Sibling
25.0 – Second Sibling Please fill out this field.

Total:

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OUR LADY OF GOOD COUNSEL