High School Fall Retreat: Lion Of Judah (register)

“I have said this to you, that in me you may have peace. In the world you have tribulation; but be of good cheer, I have overcome the world” ~ John 16:33

Fall Retreat Registration

All high school youth are invited to join us as we retreat to Tiger, GA, at Camp Covecrest for a weekend of prayer. Teens will reflect on the majestic nature of Jesus as the just, powerful, and victorious Lion of Judah. Sign up through the form below and pay on our parish website HERE by October 31.

High School Fall Retreat Form

Register here for our High School Fall Retreat, November 7-9, at Camp Covecrest. Participants must currently be in 9th – 12th grade in the 2025-2026 school year to register. Registration is not complete until payment has been submitted.

Name of Participant(Required)

First Last

Date of Birth(Required)

MM slash DD slash YYYY

Grade(Required)

9th Grade

10th Grade

11th Grade

12th Grade

Sweat Shirt Size(Required)

Parent Name(Required)

First Last

Parent Email(Required)

Allergies or Health Concerns(Required)

Current Medication (and dosage)(Required)

Medication Consent(Required)

I grant permission for non-prescription medications to be given, if deemed appropriate by adult chaperone(s).

Emergency Contact Person(Required)

First Last

Emergency Contact Phone(Required)

Relationship to Participant(Required)

Insurance Carrier(Required)

Policy Number(Required)

Copy of Insurance Card

Max. file size: 200 MB.

Parental Consent(Required)

I hereby give my approval for my son/daughter to participate in the Fall Retreat to Life Teen Camp Covecrest, sponsored by Mary Our Queen Catholic Church. I do hereby, for myself, my heirs, executors, and administrators, waive, release, absolve, indemnify, and agree to hold harmless any and all adults who chaperone, also the Archdiocese and its representatives, successors, supervisors, sponsors, organizers, and participants for any injuries in connection with the program named above. I likewise release from my responsibility any person transporting my child to and from any of the activities.

I give consent to the above.

Medical Consent(Required)

I agree to the below.

I give permission to seek any emergency care should my child be involved in any accident or be injured in any way during the events named above. I understand that in any such instance, all attempts will be made to contact the parent/guardian. If I cannot be contacted, I hereby permit the attending physician to hospitalize, secure treatment for, and to order injection, anesthesia, and/or surgery for my child, as named herein.

Parental Responsibility Consent(Required)

I agree to the below.

I agree that I am legally responsible for all/any personal actions taken by my child/guardianship during this event, and agree to be financially responsible for any/all damages, legal fees, and other costs incurred as a result of the actions/behavior of my child/guardianship.

Participant Conduct Consent(Required)

I agree to the below.

Furthermore, I agree that if the above-named student’s behavior is inappropriate, unsafe and/or detrimental to the group, I will be contacted immediately to secure means of removing my child/guardianship from the event premises. I understand that any financial costs incurred as a result of my child/guardianship being sent home are my responsibility.

I hereby grant permission for the publication of photos of groups (two or more persons) taken at youth events.(Required)

Yes

Parent/Guardian Signature(Required)

In signing this form, I certify that all information contained herein is true and accurate to the best of my knowledge.