What is an Agape retreat Weekend?
Agape is specifically focused on helping Freshman students bridge the gap from Junior High to High school
in their faith journey. When we look at the cross, we often recognize the Love that Christ had for us as “Agape love” - a Love that is unconditional. The Agape retreat will focus on this Love and the call we have
to forgive others and ourselves.
What is the weekend like?
It is a dynamic 2-day retreat full of sharing, discussion, music, fun, projects, and more. The weekend is facilitated entirely by experienced young adults from Ball state University. You will be glad you came!!
Who can go?
The Agape retreatwill be held at Our Lady of Mount Carmel parish on November 18-19, 2017. The retreat is open to all Freshman students. An open heart is all that is required to make it a meaningful retreat for you and your friends. We will be taking only 30 Freshman students and spots fill up quickly!
How do I register?
Just complete the registration form, have your parents fill out theParental permission and Medical/Emergency portion, and send it along with a check for $40.00 made payable to Our Lady of Mount Carmel. Please note that registrations for the weekend are limited in number, and registrations will be processed as received. The deadline for registrations is Friday, Nov. 10, 2017. Because of the volume of forms and strict registration guidelines, if the quota is met prior to this date or if any forms are received after this date, remaining names will be placed on a waiting list in the order received. Any questions, please contact Louis Paiz at 317-663-4004 or email Louis at
Where do I send the registration form?
Our Lady of Mount Carmel
14598 Oak Ridge Rd Attn: Louis Paiz
Carmel, Indiana 46032
Keep this Page for your records
Please return Registration form and payment to the Faith Formation office
no later than Friday, November 10, 2017.
FRESHMANRegistration/AGAPERetreat(Top portion to be completed by Freshman)
Preferred Name______Date______Gender: M / F
First Last
Parish______School Attending______
Parent Email______Adult T-shirt size: S M L XL XXL
Youth Email______Age______Grade______
My hobbies are:
I would describe myself as:
I would like to come to this weekend because:
I heard about it from:
Other retreats/conferences I have attended:
Freshman: I plan to attend the entire AgapeRetreat, November 18-19, 2017
I have enclosed a check for $40.00 with this registration
*For Financial Assistance, please contact the Faith Formation office at 317-846-3878 to receivea Financial
Assistance application.
Freshman Signature______
Parental Permission
(To be completed by Parent)
We, the parents or guardians of______, permit our son/daughter to participate in the Agape Retreat weekend held atOur Lady of Mount Carmel from Saturday, Nov. 18, 2017–9:30am through Sunday, Nov. 19, 2017- 1:30pm. We, the parents/guardians of the undersigned minor, hereby consent to hold harmless, the Roman Catholic Diocese of Lafayette-in-Indiana, Inc., and any and all employees or volunteers thereof, for any accident, injury or occurrence arising out of, or in connection with, the activity and our child’s event-arranged transportation necessary to participate in the aforementioned activity. I give my permission for my son/daughter, in case of an emergency, to be taken to a physician or hospital by either a parent in charge or by parish personnel. I understand that every effort will be made to contact me. I understand that this event is being carefully and professionally planned and it is to be held at Our Lady of Mt. Carmel parish for the entire weekend. I am aware that the youth will be sleeping in assigned sleep groups separated by gender. I understand that every adult working with my son/daughter has completed the Protecting God’s Children in the 21st Century protocol training and have met diocesan standards for working with youth. I fully expect to be notified if my child is disrespectful or uncooperative. I know that great care will be taken and that my child will be offered plenty of good food and rest.
Please fill out the Medical/Emergency information on the back of this sheet.
Parent Permission/Signature______Date______
Our Lady of Mt. Carmel Parish Media Release
We believe that both the youth and the parish benefit from positive recognition. There may be occasion for Catholic media coverage concerning your youth throughout the year. We ask permission to release this type of communication. This could include: Catholic Newspapers, newsletters, OLMCObserver and OLMC and Diocesan websites.
______Yes. The parish has my permission to release Agaperelated communication involving my youth to the media.
______No. The parish does not have my permission to release Agaperelated communication involving my youth to the media.
______
Parent Signature Date
AGAPERetreatMedical/Emergency Waiver
______
STUDENT: Last Name, First Name Grade Date of Birth
______
ADDRESS City Zip Code
______
Father’s Home phone #Work Phone # Cellular Phone # Father’s Name
______
Mother’s Home phone #Work Phone # Cellular Phone # Mother’s Name
Who does your child live with?______
In case of an emergency, if parent is not available, please contact: (List 2 friends or relatives)
1.______
Full name Phone # Relationship
2. ______
Full name Phone # Relationship
Do we have your permission to administer Benadryl / Diphenhydramine HCL? Yes No (Circle One)
I hereby grant permission for nonprescription medication (such as Tylenol, throat lozenges, cough syrup) to be given to my child, if deemed advisable, EXCEPT for the following:______
Please list allergies/sensitivities: (Food, medications, bee stings, etc):______
Will your child require medication during this retreat? Yes No (circle one)
*Please note: All prescribed medication must be brought in its original container with dosage instructions on containerandplaced in a zip-loc bag with medication card (card will be provided in the Parent letter mailed when we receive registration form)
If Yes: Medication ______Dosage______Time______
Any additional information you can provide us to help make your youth’s stay comfortable, will be appreciated.
______
Child’s Physician: ______Office Phone: ______After Hours: ______Hospital Preference:______
Medical Insurance Provider ______Policy #______
I give my permission for Church personnel to obtain needed medical services for my son or daughter and to transport him or her to a hospital should the above named youth suffer illness or accident and the parent(s)cannot be contacted.
______
Parent Signature Date