July 13-16, 2021 Registration deadline is June 23, 2021 "*" indicates required fields Name* Gender* How would you like your name to appear on your name tag?* Address* Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Home Phone*Student Cell Phone*Student E-mail* School* Grade*Age*Must be 16 years old to attendDate of Birth* MM slash DD slash YYYY Are you a member of St. Anne?*All religious affiliations are welcome. Yes No If you belong to another parish or church community, which one?* Mother's Name* Father's Name* Mother's Cell Phone*Father's Cell Phone*Mother's Email* Father's Email* Important: Please watch your email for retreat details as your child’s retreat date draws closer. Online Registration, Parent Permission Form, Archdiocese of Chicago Form, COVID 19 Verification, and your payment of $350.00, must be received in order for your registration to be complete. Make checks payable to Saint Anne Youth Ministry. Forms are available on-line and checks can be mailed to: Saint Anne Youth Ministry 120 North Ela Street Barrington, IL 60010 Registration Due: June 18, 2021 Parent Permission Form: Due: June 18, 2021 Archdiocese of Chicago Form Due: June 18, 2021 COVID 19 Verification Due: June 18, 2021 Payment Due: June 18, 2021 Registration is on a first-come basis (complete registrations). If registration goes beyond capacity we will give priority to Saint Anne parishioners. No refunds can be made after June 28, 2021 NO EXCEPTIONS Questions? Please contact Joe Tomaso at 847-620-3073 or at firstname.lastname@example.org or Doreen Sobeski at 847-620-3072 or at email@example.com PhoneThis field is for validation purposes and should be left unchanged.