Please provide the following contact information:

Name
Age		M F	Fr So Jr Sr
Local Address
Phone #
Email
Emergency Contact
Allergies, Dietary Needs

Do you help at Mary Immaculate?**

Yes No

T-Shirt Size

PLEASE ANSWER THE FOLLOWING QUESTIONS

What do you want to be if you grow up?

What is your favorite Candy?

What is your favorite Color?

What three people would you most like to have dinner with?

Favorite Bible Verse:

Favorite Quote:

3 Adjectives to describe you:

What would you like to get out of this retreat?

Favorite/Confirmation Saint

Anything else we should know?