1720 East Covina Boulevard, Covina, CA 91724-1640 Phone: 626-915.7873 www.stlouisedm.org FAX: 626.332-4431

12/8/2016

Dear Confirmation Year 1 Parents,

PLEASE DO NOT LET YOUR SON/DAUGHTER SEE THIS LETTER! IT IS VERY IMPORTANT FOR ITS EFFECTIVENESS ON THEIR CONFIRMATION

RETREAT! THANK YOU!

Your son/daughter will soon be experiencing their Confirmation retreat at Camp Cedar Falls on February 3-5, 2017. The retreat will

provide a very significant time of prayer and reflection of their own life and future with God, themselves and others. In order for this

retreat to be a “special time” and memorable experience for your son/daughter, we definitely need your help and cooperation.

PLEASE WRITE A LETTER TO YOUR SON/DAUGHTER: In the process of the retreat experience, a “love letter,” from a parent will be given to

each candidate. To hear how special each person is to his/her parents is one of the most effective parts of the retreat experience and has

tremendous impact on each candidate. Therefore, it is crucial for each candidate to receive at least one letter from each parent. However

it would be best if we could have more from each parent and other members of the family who play a key role in the candidate’s life such

as aunts, uncles, grandparents, mentors, etc. The letter gives you the opportunity to say things you might not have yet verbalized; things

that are deepest in your heart, but have been lost in the day-to day living, and often escape being expressed. Because each parent has a

unique way of expressing these thoughts, it is important that each parent write their own letter. Please make sure to request a letter from

other adults who are important to your son/daughter. In writing your letter, please include the following:

Express the deepest love you have in your heart for your son/daughter

Share funny experiences and meaningful times you have spent together

You might consider mentioning sacrifices you are offering for them while they are on retreat

Mention how helpful he/she is to you and in what ways

PLEASE BE POSITIVE

Please do not use the letter as a time for correction and avoid negative comments.

HOW TO DELIVER YOUR LETTER: PLEASE DO NOT….give your son/daughter, or any child participating in this retreat; the letters are to be a

SURPRISE. You have several options in delivering your parent letter.

a) Deliver the letters yourself to the office (either myself or Cecilia Luna)- Monday-Thursday-9am-6pm/Friday-9am-5pm

b) Email the letter in Microsoft Word format to Confirmation@stlouisedm.org

c) Fax your letter to (626) 332-4431 and write ATTN: CONFIRMATION 2 RETREAT on the cover sheet.

Since it is not always easy to put feelings into words, this may be difficult to write, but I assure you the results will be well worth it. Please

keep in mind that this letter is essential to your son/daughter’s retreat experience. Please be sure your letter is received by me no later

than January 9, 2017 Thank you for your cooperation and assistance in making this a memorable experience for your child. Please feel free

to contact me if you have any questions or need assistance.

Yours in Christ, Toney Renteria Confirmation & Youth Ministry Coordinator

HEALTH AND MEDICAL RELEASE FORM FOR YOUTH St. Louise de Marillac Catholic Church Office of Faith Formation

1

Name ______________________________ _Date of Birth Female Male

Address ____________________________________________________________ Street, City, Zip Parish: City School_____________________________ Cell

Email________________________________________________________________________Phone ( )

Is this participant in general good health and able to participate in all activities involved in this event?

YES NO (If no, please submit a statement indicating limitations or serious medical conditions.)

Date most recent physical exam: ______________ Physician or Clinic: ___________________

Address ________________________________________ Phone: ( )

************************************************************************************************************************ IMMUNIZATION HISTORY: (Please give dates) DPT DPT BOOSTER TETANUS BOOSTER

ALLERGIES (Please write yes or no next to each) Hay Fever Asthma Poison Ivy Sulfa Nuts Penicillin Bee Sting Other

Medicines __________________________ If any of the above is yes, please submit a statement of how the child has been treated and with what medication. Any medication not able to be self-administered must be listed.

Operations or Serious Injuries: Dates: Please notify the event coordinator if this child is exposed to any communicable disease during the three weeks prior to activity.

Does the participant have any special dietary needs? If yes please list._______________________________________________________________ ________________________________________________________________________________________________________________________ AUTHORIZATION TO CONSENT TO TREATMENT OF MINOR

I/We, the undersigned, parent(s) of a minor, do hereby authorize as agent(s) St. Louise de Marillac Office of Faith Formation for the undersigned to consent to any X-Ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by and is to be rendered under the general or special supervision of any physician and surgeon licensed under the provisions of the Medicine Practice Act of the medical staff of any licensed hospital whether such diagnosis of treatment is rendered at the office of said physician or at said hospital.

It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power on the part of our for said agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care

which the aforementioned physician in the exercise of his/her best judgment may deem advisable.

I agree that in the event my child is injured as a result of his/her participation in this event, including transportation to and from such activity through the negligence (active or passive) of St Louise de Marillac Church or any of any of its agents or employees, recourse for the payment of any resulting hospital, medical or related costs and expenses will first be had against any accident, hospital, medical insurance, or any available benefit plan of mine or my spouse.

I also, give my child permission to self-medicate except for medications which are listed on the back of this form. I understand that any medications so listed will be dispensed by the Director of First Aid for the St. Louise de Marillac Office of Faith Formation. This authorization shall remain effective from February 3, 2017-Feburary 5, 2017

Signature of parent(s)/Guardian: ______________________ Date: _____ _

Emergency Telephone Number during Event ( ) ___________ Alternate Telephone ( ) _______________

Family Health Insurance Co: _____ Policy No. ______________ (If possible please provide a copy of the insurance card)

Medication(s) Name: ______________________________________________________________________________________________________

Dosage:_________________________________________________________________________________________________________________

Frequency given:__________________________________________________________________________________________________________

Other Information:________________________________________________________________________________________________________

ARCHDIOCESE OF LOS ANGELES SPORTS AND YOUTH ACTIVITY PERMISSION FORM

FORM # E.2.1 __________________________ _________________________________________________

St. Louise de Marillac Year 1 Confirmation Retreat

Camp Cedar Falls 1000 Cedar Falls Road, Angelus Oaks, CA 92305

February 3, 2017-February 5, 2017

NAME________________________________________________________T-SHIRT SIZE_______ F____ M____ SCHOOL_____________________________________________ GRADE _______ BIRTHDATE ______________ CELL PHONE _________________________ PARISH____________________________________________________ CITY

PARENT/GUARDIAN’S NAME __________________________________CELL PHONE____________________ ADDRESS __________________________________________________WORK PHONE _________________ STREET, CITY, ZIP

Email _____________________________________________________________________________________ PERSON (S) (OTHER THAN PARENT) TO NOTIFY IN CASE OF EMERGENCY:

NAME ____________________________________________________ PHONE ______________________

I, THE PARENT/GUARDIAN OF THE ABOVE NAME CHILD, HEREBY, GIVE MY PERMISSION FOR HIS/HER PARTICIPATION IN THE YOUTH ACTIVITIES NAMED ABOVE. I AGREE TO DIRECT MY CHILD TO COOPERATE AND CONFORM WITH DIRECTIONS AND INSTRUCTIONS OF PARISH, SCHOOL OR ARCHDIOCESAN PERSONNEL RESPONSIBLE FOR YOUTH ACTIVITIES.

I, AGREE THAT IN THE EVENT MY CHILD IS INJURED AS A RESULT OF HIS/HER PARTICIPATION IN THE ABOVE NAMED YOUTH ACTIVITIES INCLUDING TRANSPORTATION TO AND FROM THESE ACTIVITIES WHETHER OR NOT CAUSED BY THE NEGLIGENCE (ACTIVE OR PASSIVE) OF THE PARISH, SCHOOL OR ARCHDIOCESAN YOUTH ACTIVITIES PROGRAM, OR ANY OF ITS AGENTS OR EMPLOYEES, RECOURSE FOR THE PAYMENT OF ANY RESULTING HOSPITAL MEDICAL OR RELATED COSTS AND EXPENSES WILL FIRST BE HAD AGAINST ANY ACCIDENT HOSPITAL OR MEDICAL INSURANCE OR ANY AVAILABLE BENEFIT PLAN OF MINE OR OF MY SPOUSE.

I AM NOT AWARE OF ANY MEDICAL CONDITION OF MY CHILD, WHICH WOULD RENDER IT INAPPROPRIATE FOR HIM/HER TO PARTICIPATE IN ANY SUCH ACTIVITY.

I HEREBY GIVE PERMISSION TO THE PHYSICIAN SELECTED BY THE YOUTH ACTIVITIES SUPERVISORY PERSONNEL THEN PRESENT TO RENDER MEDICAL TREATMENT DEEMED NECESSARY AND APPROPRIATE BY THE PHYSICIAN.

ADULT LEADER: Toney Renteria-Confirmation Coordinator/Youth Minister PARENT/GUARDIAN’S SIGNATURE _______________________________________ DATE _________________ ADDRESS __________________________________________________________________________________

STREET, CITY, ZIP

NOTE: Use of any other form must be approved by the Director of Human Resources, Archdiocese of Los Angeles

St. Louise de Marillac Faith Formation 1720 E. Covina Blvd Covina, CA 91724

Office-(626) 332-5822

St. Louise de Marillac Year 1 Retreat Rules Contract

1. I will participate fully in the Retreat without hesitation. 2. I will not bring firearms, or weapons or any kind of material harmful to others. 3. I will not bring or use drugs or alcohol on this retreat. 4. I will not use or have a cell phone on me at anytime during the retreat. 5. I will not have any electronics with me on the retreat. 6. I will listen to the chaperones and leaders instructions at all times. 7. I will respect and honor all of the Camp Cedar Falls Retreat facility rules and faculty. 8. I will clean up after myself in the restrooms, cabins, kitchen and dining area. 9. I will not wander off the boundaries given by the leaders. I will let a leader know where I am at all times. 10. I will dress appropriately. 11. I will not destroy or damage any property. Failure to comply with these rules will result in dismissal from the retreat where it will be parental responsibility to pick up the child at the Retreat Center. Any damage will be the parent’s responsibility to cover all costs. If a child brings a non-permitted item, Parents will be notified and participants will be dealt with according to the violation. I have read and understand all of the rules and policy in regards to my child’s attendance. I agree to adhere to rules contract. Print Parents Name Print Students Name ___________________________ ___________________________________ Signature Student Signature ___________________________ __________________________________ Date Date ____________________________ ___________________________________

St. Louise de Marillac Confirmation Year 1

Retreat Packing List *Check the weather prior to packing.

*PLEASE BE PREPARED FOR SNOW WEATHER

What to Bring… *Bedding (sleeping bag strongly suggested)

* Comfortable Clothes

*Closed toed shoes

*Pillow

*Towel

*Wash cloth

*Shampoo

*Soap

*Deodorant

*Tooth brush &Tooth paste

*Medication (must be checked at arrival)

*Chapstick

*Sunscreen

*Bug spray

*Flip flops for shower

*Any other personal toiletries

*Flash light

*Camera

*Refillable Water Bottle

Retreat Packing Tips:

*Wear your clothes in layers

*Bring extra under garments.

*Hoodies are awesome for retreats

*Pack light: You carry what you pack

Things not to bring…

Due to the nature of this Retreat Experience,

we ask you to please leave the following

items at home.

*Cell phones

*Ipods/mp3 players

*iPads/Tablets/Laptops

*Homework (plan accordingly)

*Books

*Illegal drugs (if it’s not prescribed to you it’s illegal)

*Alcohol

*Weapons

*Drama

*A BAD ATTITUDE

Each student is required to bring 1 snack item and 1 drink item

to share with 10 people. Some examples are cookies, cheese

its, chips, fruit cups, Capri suns, Gatorades, water etc. All snacks

collected will be utilized for Confirmation Year 1 students

during breaks and meals.

All snack/drink items are due January 23, 2017 at the

Faith Formation Office.

Thank you,

Toney Renteria

Confirmation & Youth Ministry Coordinator

Office of Faith Formation

1720 E. Covina Blvd. Covina, CA. 91724 + @demarillacyouth + (626) 332-5822

FAQ (Frequently Asked Questions)

Year 1 Confirmation Retreat

Date: February 3-5, 2017

• In case of Emergency Please call 626-214-7841 • Our team will send out a text via remind when we arrive safely at the

retreat site. • All medication must be turned into the Coordinator, Toney Renteria,

which will be self-administered. • Arrive at St. Louise in front of the Faith Formation Office on

February 3, 2017 by 4:30pm • Return Time: We will return on Sunday, February 5, 2017 12:30pm.

• The retreat will end at 12:30pm *Location: Camp Cedar Falls

1200 Cedar Falls Road, Angelus Oaks, CA 92305

Office of Faith Formation

1720 E. Covina Blvd. Covina, CA. 91724 + @demarillacyouth + (626) 332-5822

1. Start out going east on E Covina Blvd toward N Garsden Ave.

Then 1.17 miles1.17 total miles 1. 2. Turn left onto W Covina Blvd. 1. W Covina Blvd is just past Kimberly Ave

Then 0.76 miles1.93 total miles 2. 3. Merge onto CA-57 S/Orange Fwy S. 1. If you reach W Terrace Dr you've gone about 0.1 miles too far

Then 2.15 miles4.08 total miles 3. 4. Merge onto I-10 E toward San Bernardino.

Then 37.91 miles41.99 total miles 4. 5. Take the University St exit, EXIT 80.

Then 0.27 miles42.26 total miles 5. 6. Turn right onto N University St.

Then 0.04 miles42.30 total miles 6. 7. Take the 1st left onto E Citrus Ave. 1. If you are on S University St and reach Lytle St you've gone a little too far

Then 2.60 miles44.90 total miles 7. 8. Turn left onto Crafton Ave. 1. Crafton Ave is 0.2 miles past King St 2. If you are on Citrus Ave and reach B St you've gone about 0.5 miles too far

Then 0.99 miles45.89 total miles 8. 9. Turn right onto Mentone Blvd/CA-38. Continue to follow CA-38. 1. CA-38 is 0.1 miles past Marble Dr 2. If you reach Sierra Pine Dr you've gone about 0.1 miles too far

Then 18.82 miles64.71 total miles 9.

10. 39850 State Highway 38, Angelus Oaks, CA 92305-9799, 39850 STATE HIGHWAY 38 is on the left. 1. If you reach Cedar Falls Rd you've gone a little too far

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