HOLY TRINITY YOUTH MINISTRY
w/ All Saints Youth Ministry
Ultimate Outing"Retreat & Rally”

October 22-23, 2016

All Saints & Holy Trinity Parish are teaming together for this event. There are two aspects that make up one Ultimate Outing: a retreatcomponent followed by a rallycomponent.

Please select one:

Retreat only:

  • Meet at Holy Trinity at 7am Sat, Oct 22 / Return to Holy Trinity by 11am Sun, Oct 23
  • Meals: Lunch and Dinner on Saturday and breakfast on Sunday.
  • Held in Newburg MD, this retreat mixes spiritual, social, sacramental,fun, relaxation and other elements to provide a needed weekend away for teens.
  • Cost: $50

Rally only:

  • Meet at Holy Trinity at 11am Sun, Oct23 / Return to Holy Trinity by 9pm Sun, Oct 23
  • Meals: Sunday Dinner
  • Held at O’Connell Catholic High School.Over 1,000 Catholic teens expected to attendtocelebrate our Catholic faith!Day includes music by Josh Blakesley Band,Christian Illusionist Sean Forrest, speaker Danny Ray and Mass with Bishop Loverde!
  • Cost: $25(includes a long-sleeve Youth Rally t-shirt)

Ultimate Outing (Retreat AND Rally combo):

  • Meet at Holy Trinity at 7am Sat, Oct22 / Return to Holy Trinity by 9pm Sun, Oct 23
  • Cost includes a long-sleeve Youth Rally t-shirt, transportation, lodging, and all meals for the weekend.
  • Cost: $60 (best value!)… Register by Sunday October 9 and payONLY $50!

Deadline:October 16, 2016 or earlier if spaces already filled (limited space)

Questions?Contact Tim at 703-753-6700 x117 or

PERMISSION SLIP

Name: Birthday:
Phone: (H) (C)
Address:
Email:
School: Graduation Year:
T-shirt Size (Adult):
Parent Driver Available:

Parental Permission and Liability Release:

As parent/legal guardian of the participant named above, I (we) do hereby give my (our) permission for him or her to participate fully in the event described above. I (we) do for myself (ourselves) and for and on behalf of my (our) child (referred to here as "participant") do release, forever discharge and agree to hold harmless Holy Trinity Church, its directors, members, and agents thereof from any and all liability, claims, and demands for personal injury, sickness and death, as well as property damage and expenses of any nature whatsoever which may be incurred by the undersigned or the participant resulting from said participant's involvement in the above described event (including transportation between the participant's home, Holy Trinity Church, and the event location). I (we) on behalf of the participant hereby assume all risk of personal injury, sickness, death, damage, and expenses resulting from said participant's involvement in the above described event.

Further, authorization and permission are hereby given to Holy Trinity Church, its directors, members, and agents thereof to furnish any necessary transportation and food for the participant while he or she is involved in the above described event. I (we) hereby authorize Holy Trinity Church, its members, employees, and agents thereof to admit the participant to a doctor, hospital, or other licensed health care provider for medical treatment and assume full responsibility for all costs of such treatment. Further, should it be necessary for the participant to return home due to medical, disciplinary, or other reasons I (we) do hereby assume responsibility for the participant's transportation home and any costs related thereto.

Emergency Contacts:

Name / Home Phone / Cell Phone

Health Information:

Are there any conditions or allergies (food, etc.) which may affect the participant's involvement in the above described event? YES NO If “Yes”, please explain:

Is there any physician prescribed or other medication which the participant may be taking during the above described event?YES NO If “Yes”, please provide name, dosage, and potential side effects of medication(s):

I (we) understand and hereby agree to the terms and conditions of the participant's involvement in the above described event.

Parent Name (Printed) / Parent Signature
Parent Home Phone / Parent Cell Phone