St. Rose of Lima church

Confirmation Track 2 Retreat

- Religious Education

We are thrilled to announce our upcoming confirmation retreat! We have emailed your consent forms and retreat information. Kindly submit these forms by Friday, Feb 21. Payments are to be made in full by Feb.21, 2025. For any inquiries, please email Tamien Bashkiroff at: [email protected].
Tamien, Teresa, Christian, and our leaders have been diligently working on creating a memorable retreat for your teens.

Retreat Form
*Youth Activity Permission Form*

Parent/Guardian Release Form
*Release for Student Form*
Confirmation track 2
- Activity: Track 2 Confirmation Retreat - See e-mail.
- Day/Dates: Friday, March 14th, 2025, 4:30 pm to Sunday, March 16th, 2025, Buses leave camp at 12:30pm. More info. to come.
- Destination: Circle V Ranch Camp, 2550 Highway 154, Santa Barbara, CA 93105 (Drop off at St. Rose Hall on Friday 3/14 at 4:30pm, bus transportation will be provided to and from the retreat center)
- Cost: $200 - Covers the cost of room & board for the weekend, 5 meals, bus, and supplies.
- Leader: Tamien Bashkiroff
- Attire: Please choose clothes according to the weather. Pick something comfortable, modest and outdoors-friendly. No midriff or spaghetti strap tops. Athletic shoes/sneakers are best as there will be occasional running on grass. Jeans and casual shirts are recommended.
- Please bring your Confirmation shirts for Sunday Mass
Retreat payment form - track 2
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- Parents Name REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Childs Name REQUIRED Please fill out this field. Please enter valid data.
- Childs Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Email Receiving Correspondence REQUIRED Please fill out this field. Please enter an email address.
- I request that my son/daughter be permitted to participate in the above activity. My child has no medical condition that would render it inappropriate for him or her to participate in this activity. I have completed the Medical Information portion on my child’s registration form at the parish. I agree to direct my child to cooperate and conform to the directions and instructions of the parish, volunteer, or archdiocesan personnel responsible for this activity.
  
  As a condition of participating in this activity, I hereby release and discharge The Roman Catholic Archbishop of Los Angeles, a corporation sole, Archdiocese of Los Angeles Education & Welfare Corporation and the school and parish, their respective employees and any parent/volunteer chaperone, from any and all claims for personal injuries, wrongful death or property damage that my son/daughter may suffer as a result of participation in the activity described above, whether or not such injuries or damage are caused by negligence ( active or passive) of the Archdiocese, the parish, the school or their employees or chaperones.
  
  Should it be necessary for my son/daughter to have medical treatment while participating in this trip, I hereby give the responsible personnel or chaperones permission to use their judgment in obtaining medical service, and I give permission to the physician selected by the personnel or chaperone to render medical treatment deemed necessary and appropriate by the physician. I agree to relieve the parish, and other participating adults from the liability in connection with this request.
  I understand that the insurance benefits through the parish, if any, may have limited application, and that I am entirely responsible for the cost of all medical treatment provided to my child.
  
  I AGREE to indemnify and hold the school and parish harmless from the cost of any medical treatment and related expense and cost incurred. Please select this field.
- Date REQUIRED
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  Please fill out this field. Please enter a date.
- Payment in Full Total200.0
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