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Fearless Ministries April 29, 2023 - Kennedy Catholic, Somers, NY Participant Registration Form

Note: Parents and families are welcome to stay for the whole retreat but not required to do so. If you plan to stay for the whole day, please register here with your child(ren). Everyone attending the retreat must register.

If there are more than 5 of you, fill out all five spaces here and then email Fearlessretreats@gmail.com with the names of subsequent family members. *you will be welcome to join us for adoration anytime after 6:30pm (no registration needed).

Registrant First Name *

Registrant Last Name *

Gender * 🛈

Date of Birth
(mm/dd/yyyy) *

Registrant First Name 🛈

Registrant Last Name

Gender 🛈

Date of Birth
(mm/dd/yyyy)

Registrant First Name

Registrant Last Name

Gender 🛈

Date of Birth
(mm/dd/yyyy)

Registrant First Name

Registrant Last Name

Gender 🛈

Date of Birth
(mm/dd/yyyy)

Registrant First Name

Registrant Last Name

Gender 🛈

Date of Birth
(mm/dd/yyyy)

Registrant First Name

Registrant Last Name

Gender 🛈

Date of Birth
(mm/dd/yyyy)

Please list the name of the adult chaperone accompanying your group here: (If unknown, or you are not with a parish group write "unknown" and we will contact you): * 🛈

Parent or Guardian name(s): *

Street address:

City:

State:

Zip:

Primary phone (or parent's phone if under 18):
xxx-xxx-xxxx: *

Alternative phone 1:
xxx-xxx-xxxx

Primary e-mail (must list parent's email if under 18): *

Verify email address *

Note: An e-mail will be sent to this primary (or parent) e-mail from fearlessretreats@gmail.com to confirm your registration and send additional information as needed.

Choose Event(s) *

April 29, 2023 at Kennedy Catholic High School, Somers, NY

Parish (or youth group) name: (No abbreviations please)

Parish city:

Parish state:

Form Login Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish the form. The account you establish is only for this form.

Have you ever attended Camp Veritas? *

Yes

Have you attended a Fearless Retreat before? *

Yes!

No, this is my first Fearless Retreat.