Pre-Retreat Questionnaire

Please help us prepare for your visit to Fr. Bernard Youth Center by returning the questionnaire as soon as possible. , fax (503) 845-2208 or send to PO Box 790, Mt. Angel, OR 97362.

Parish/Organization Click here to enter text.Contact Person Click here to enter text.

Number of Adults0Number of Youth0Total Attendees Choose an item.

Arrival Time/Date

Leader(s) //at : Others // at :

Departure Time/Date

Leader(s) //at : Others // at :

FBYC Scheduling - Requests for Priests, Service Work and/or Activities need to be made at least 30 days prior to retreat date in order for us to have the best chance at accommodating.

MASS and/or RECONCILIATION (Please check all that apply)

For Mass at FBYC, please help Father by pre selecting your Liturgists, Eucharistic Ministers, Servers, etc. Also please assign someone to set up for the Liturgy in the Sacristy including preparing the Gifts, counting HOSTS, pouring WINE, etc.

☐We will be using the FBYC Chapel

Day 1 // at : ☐Please schedule Priest ☐ Our own Priest(s) will be coming

Day 2 // at : ☐Please schedule Priest ☐Our own Priest(s) will be coming

Day 3 // at : ☐Please schedule Priest ☐ Our own Priest(s) will be coming

☐ Reconciliation Service : on // ☐Please schedule Priest/s No

☐Our own Priest(s) will be coming

☐ Mass at : on //

SERVICE WORK

☐No Service Work ☐Wewill scheduled our own Service Work☐Please Schedule Service Work for us

First Choice:Choose an item.Second Choice: Choose an item.Third Choice: Choose an item.

Specify Other: Click here to enter text. Click here to enter text. Click here to enter text.

Date/Time: //from : to : # of People # of Groups

Date/Time: //from : to : # of People # of Groups

Date/Time: //from : to : # of People # of Groups

ACTIVITIES

☐Please arrange a visit(s) to: 1st Choice: Choose an item.2nd Choice: Choose an item.

Specify Other: Click here to enter text. Click here to enter text.

Date/Time: //from : to : # of People # of Groups

Date/Time: //from : to : # of People # of Groups

FBYC Facility NeedsAudio/Visual Equipment Needs

Great Room/Dining Hall

(This room has an audio/visual system; up to 4 wireless mics, 3 fixed mics, video projection from front or from sound booth, HDMI, VGA, micro audio jack and blue-tooth sound connection)

☐Sound system# of wireless mics Choose an item. # of fixed mics Choose an item.☐Video Projector

☐Dry Erase Boards

Room Set Up: Choose an item.

Other Comment: Click here to enter text.

Fire Side Room

(This room has an audio/visual system; 1 wireless mic, up to 3 fixed mics, video projection, HDMI, VGA, micro audio jack and blue-tooth sound connection)

☐Sound system☐wireless micChoose an item. # of fixed mics Choose an item.☐Video Projector

☐Dry Erase Boards

Room Set Up: Choose an item.

Other Comment:Click here to enter text.

Annex-Games Room

Portable Audio System (up to 4 inputs),# of fixed mics Choose an item. ☐Guitar Input ☐Keyboard Input

☐Portable Video Projector & Screen ☐Audio for Projector

☐Dry Erase Boards

Room Set Up: Choose an item.

Other Comment: Click here to enter text.

Conference/Leaders Room (We prefer this Room is used for Adults and Leaders Only)

(This Room has Video Projection with HDMI & VGA)

☐Smart Board (Electronic White Board)

☐Audio for Projector

☐Dry Erase Boards

Chapel

(The Chapel has a full audio system; 1 wireless mics, up to 8 fixed mics, micro audio jack connection and CD Player)

☐Music set up - at the Front☐ wireless mic, # of fixed mics Choose an item.☐Lav Mic ☐ Altar Mic

☐Music set up - at the Back☐ wireless mics, # of fixed mics Choose an item.☐Lav Mic ☐ Altar Mic

☐Video Projector & Screen ☐ Audio for Projector

Chapel Set Up: Choose an item. Number of Chairs Number

Other Comment: Click here to enter text.

Outdoor Activities

☐Upper Fire Pit ☐Lower Fire Pit ☐ Volleyball Net ☐Bocce Ball ☐ Traeger Grill ,

☐Other Click here to enter text.


FBYC Catering- Final counts for catering are required at least one week prior to arrival. While we will do our best to accommodate last minute changes, the caterer(s) have usually finished their shopping for meals at this time and may not be able to reduce, or increase the number of meals ordered.

Please list dates, times and quantities for each meal ordered

Day 1 //

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

Day 2 //

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

Day 3 //

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

Day 4 //

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

Day 5 //

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

: Choose an item.for people

Additional Information, Special Needs, Etc.

Click here to enter text.

  • Sleeping bag, Pillow or Bedsheets (for a Twin bed) and blankets.

Please note, failure to have your youth/adults use sleeping bags or bedsheets will incur a laundry cost of $18.00 per bed. This is the cost for us to launder the mattress protectors.

We can provide bedlinen for anyone who has forgotten to bring a sleeping bag or bed sheets at an additional cost of $15.00 per set.

  • Bible
  • a note block and pen for writing
  • Modest pajamas, or sleep ware
  • Bath towel, toiletries,
  • medication if needed etc
  • Warm, comfortable clothing, jacket etc in the winter months –Oct-May (This is Oregon)
  • Light comfortable clothing & a hoodie for the evenings in Summer (June-Sept)
  • Comfortable shoes for walking is not a bad idea

You may want to consider asking your group to:

Bring snacks/drinks to share with the group during your social times

and

Not to bring cell phones and other electronic items; these can be very distracting during a retreat

S:\Documents\Retreat Contracts and Forms\Retreat Preparations\Pre-Retreat Documents\Pre-Retreat Questionnaire.doc