CYM Retreat / Trip Registration

Youth Information

Number of Youth Registering REQUIRED Please fill out this field.
Youth 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade Level (2025-2026) REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Youth's Email (If Applicable) Please enter an email address.
- Youth's Cell Phone Number (If Applicable) Maximum 20 characters Please enter a phone number.
- Indicate whether you authorize this youth to receive communications from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.
- Does this student have any allergies or special needs? REQUIRED Yes (please list in comments below) No Please fill out this field.
- Comments
Youth 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade Level (2025-2026) REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Youth's Email (If Applicable) Please enter an email address.
- Youth's Cell Phone Number (If Applicable) Maximum 20 characters Please enter a phone number.
- Indicate whether you authorize this youth to receive communications from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.
- Does this student have any allergies or special needs? REQUIRED Yes (please list in comments below) No Please fill out this field.
- Comments
Youth 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade Level (2025-2026) REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Youth's Email (If Applicable) Please enter an email address.
- Youth's Cell Phone Number (If Applicable) Maximum 20 characters Please enter a phone number.
- Indicate whether you authorize this youth to receive communications from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.
- Does this student have any allergies or special needs? REQUIRED Yes (please list in comments below) No Please fill out this field.
- Comments
Youth 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade Level (2025-2026) REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Youth's Email (If Applicable) Please enter an email address.
- Youth's Cell Phone Number (If Applicable) Maximum 20 characters Please enter a phone number.
- Indicate whether you authorize this youth to receive communications from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.
- Does this student have any allergies or special needs? REQUIRED Yes (please list in comments below) No Please fill out this field.
- Comments
Youth 5
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade Level (2025-2026) REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Youth's Email (If Applicable) Please enter an email address.
- Youth's Cell Phone Number (If Applicable) Maximum 20 characters Please enter a phone number.
- Indicate whether you authorize this youth to receive communications from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.
- Does this student have any allergies or special needs? REQUIRED Yes (please list in comments below) No Please fill out this field.
- Comments
Youth 6
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade Level (2025-2026) REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Youth's Email (If Applicable) Please enter an email address.
- Youth's Cell Phone Number (If Applicable) Maximum 20 characters Please enter a phone number.
- Indicate whether you authorize this youth to receive communications from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.
- Does this student have any allergies or special needs? REQUIRED Yes (please list in comments below) No Please fill out this field.
- Comments
Youth 7
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade Level (2025-2026) REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Youth's Email (If Applicable) Please enter an email address.
- Youth's Cell Phone Number (If Applicable) Maximum 20 characters Please enter a phone number.
- Indicate whether you authorize this youth to receive communications from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.
- Does this student have any allergies or special needs? REQUIRED Yes (please list in comments below) No Please fill out this field.
- Comments

Parent / Guardian Information

Parents / Guardians REQUIRED Please fill out this field.
Parent / Guardian 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Indicate whether this parent/guardian would like to receive communication from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.
Parent / Guardian 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Indicate whether this parent/guardian would like to receive communication from St. Anne Youth Ministry via the GroupMe App. REQUIRED Please fill out this field.

Emergency Contact Information

Emergency Contact (Other than Parent/Guardian)

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.

CYM Program Code of Conduct and Expectations

I/we, the parent(s) or guardian(s) listed above, grant permission for the youth named above to participate in this St. Anne Youth Ministry event/retreat.

I/we understand that CYM events will take place under the supervision and direction of parish staff and/or volunteers from the parish and/or Diocese of Savannah.

I/we agree to support and participate in all communications relating to this event.

I/we have reviewed the St Anne CYM Code of Conduct (linked above) with our youth and agree to abide by it during all St. Anne Youth Ministry activities.

I/we have reviewed and signed the PERMISSION SLIP form (linked above) and will return a copy, either scanned to my email macrina@stannerh.org or via hard copy, to the Youth Minister, Macrina West, prior to the start of the Encounter Retreat on May 1.

I/we have reviewed and signed the LIABILITY, MEDICAL, AND CONSENT form (linked above) and will return a copy, either scanned to my email macrina@stannerh.org or via hard copy, to the Youth Minister, Macrina West, prior to the start of the Encounter Retreat on May 1.

ACKNOWLEDGE REQUIRED AGREE Please fill out this field.

Overnight Stay? REQUIRED No Yes Please fill out this field.

Payment Information

Payment/Scholarship Request is due at time of registration.

A retreat fee of $20/youth will be used to cover the cost of materials and food.

Scholarships and payment plans are available. No family will be turned away due to financial circumstances. Please email macrina@stannerh.org discuss options that are available to your family.

Saint Anne
Catholic Church

Richmond Hill, Georgia

Documents TO PRINT/SIGN

Documents TO VIEW

CYM "ENCOUNTER" Retreat Registration