HSDW Landing Page

Parent / Guardian #1 Contact Information

This is the primary contact for your youth for the Catholic Formation Department.

Parent / Guardian #1 Name:

First

Last

Parent / Guardian #1 Email:

Parent / Guardian #1 Phone Number:

Emergency Contact?

This person is the emergency contact

Parent / Guardian #2 Contact Information

Parent / Guardian #2 Name:

First

Last

Parent / Guardian #2 Email:

Parent / Guardian #2 Phone Number:

Emergency Contact?

This person is the emergency contact

General Information

Your Primary Church:

Event Information (2026 High School Discipleship Weekend)

Description of Event: Weekend Event
Date of Event: 11/13/26 – 11/15/26
Transportation Method: TBD
Participant cost: $150 per participant
Sponsored by: Immaculate Conception Church & St. Patrick Church
Supervised by: Karen LaBossiere and volunteer chaperones

Participant Registration Section

Please fill out the form below for each youth that you are registering. To add another child, please click on the “Add Youth” button at the bottom of the form for more youth forms.

Youth Registration

Youth's Name:

First

Last

Youth's Address

Address Line 1

Address Line 2

City

State

Zip Code

Youth's Phone (if applicable)

Date of Birth:

Gender:

Grade Level (Current):

Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.):

Do you need to submit a Medication Consent Form for this youth?

Yes

If you selected “Yes”, you need to submit a Medication Consent Form. Please download the form here, fill out the form digitally and upload the completed form on the next page. Please include your youth’s name within the saved form’s filename.

Participation Permission

I consent and give my permission

I give permission for my youth to participate in the above named event. My signature below indicates that I understand the risks and hazards associated with this event, including injury, illness and the rare possibility of death. I understand that I may discuss any concerns or questions I have about this event with a representative of the parish or Diocese of Superior prior to giving permission for my youth to participate.

In consideration for my youth’s participation, I agree to reimburse and indemnify the above named parish and the Diocese of Superior for all reasonable legal and court fees incurred by the parish/diocese in defending a lawsuit that I or my youth may bring against the parish/diocese which relates to the above named event if the parish/diocese is found not legally liable by the courts and prevails in the lawsuit. If the parish/diocese is found legally liable for any injuries sustained by my youth, this paragraph will not apply. I further agree to reimburse the diocese or any other agency for property damage or any bodily harm to other participants caused by my youth.

Youth's Primary Physician

First

Last

Physician Phone Number:

Health System & Location

Health Insurance Carrier

Policy Number

Signature

Clear Signature

Required Forms

Please upload any necessary medical forms below.

Form Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Please be sure that the youth’s name is contained within the file name.

Photo, Video & Likeness Policy

Effective July 1, 2025, our policy for the use of photos, video recordings, and other likenesses at all church functions has gone into effect. Please view it here.

Required Acknowledgement

Yes

I acknowledge that I have read through all policies and filled out the appropriate information to register the youth in this submission for the ICSP sponsored EFC trip.

Name of person acknowledging above:

ICSP Payment Section

The cost per registrant is $150 for the weekend. Financial scholarships may be available; the request can be made here.

Number of Youth that You Are Registering

Selected Value: 1

Payment Type:

Total Non-Refundable Deposit Due for Registration:

Price is in Dollars (USD)

Name of Person Filling Out This Form:

Emergency Name: Consent

Registration Submission

Your registration is incomplete until you click on the “Submit” button below, and you receive a confirmation on your screen.

SATURDAY	5:00 PM
SUNDAY	9:00 AM

TUESDAY	5:00 PM
WEDNESDAY	10:00 AM	8:15 AM Non-School Year
THURSDAY	8:15 AM
FRIDAY	8:15 AM

HSDW Landing Page

High School Discipleship Weekend

Parent / Guardian #1 Contact Information

Parent / Guardian #2 Contact Information

General Information

Event Information (2026 High School Discipleship Weekend)

Participant Registration Section

Youth Registration

Required Forms

ICSP Payment Section

IMPORTANT NOTICE TO ONLINE PAYERS:

Make your payment online:

Make your payment online:

Make your payment online:

Make your payment online:

Make your payment online:

Make your payment to the ICSP Business Office:

Registration Submission