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AYC 2022

registration is Open!

July 29-31, 2022
hilton of the Americas, Houston Texas
PROMO VIDEO
REGISTER TODAY!
- More Information...
  
  Join us July 29-31, 2022 for the Archdiocesan Youth Conference here in Houston Texas!
  
  The Archdiocesan Youth Conference (AYC) gathers youth of local parishes in the Archdiocese come together to pray, praise, and adore God. As of now, the conference will be held at the Hilton Americas Hotel and the George R. Brown Convention Center.
  
  Through this event, young people are challenged to live out their faith, learn from exciting and informative presentations from outstanding national speakers and musicians, and make new friendships. The Youth Conference also provides youth with a unique opportunity to interact with the Cardinal and Auxiliary Bishops of the Archdiocese to pray, dialogue and reflect on the role of the young church of Galveston-Houston.
  
  Participants will experience the diversity of the Archdiocese of Galveston-Houston and will also have the opportunity to share and deepen their faith through daily liturgy and prayer experiences.
  
  Cost: $259.
  The total cost of AYC will be comprised of two payments, a non-refundable deposit of $100 due by June 30th, and a second payment that will be due by July 18. The second payment will be put towards housing, snacks, drinks, pizza, and a t-shirt. Cost does not include dinner on Friday night and any extra spending money for the weekend (there will be multiple Catholic Vendors available throughout the weekend). Payment plans can be arranged!
  
  Because of limited capacity, you take on responsibility for full payment of the reserved spot at the conference by registering.
  
  **Parents will be responsible for dropping off and picking up their teens - this saves us the additional cost of a Bus**
- Registration summary
  
  To register for AYC please follow the link below to register through the Archdiocese. Please see the the voucher code as well. Once you have done this you may register on this website for the PARISH.
  
  You are not considered fully registered until you have filled out BOTH the Archdiocesan registration form and the one attached below!
  
  All payments will be made out to Holy Rosary Catholic Church.
  Please contact Rebecca Wolfgang de Paredez at rebecca@hrccr.com if you have any questions.
- Archdiocesan Registration for AYC
  
  Registration Website: https://archgh.cventevents.com/AYC2022
  
  Registration Voucher Code: 7873HR2022
- Holy Rosary AYC Registration - to be completed AFTER registering above.
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Please put N/A in any box that cannot be completed but is required for Submission.
  
  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.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Are you a Registered Parishioner? 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.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Are you a Registered Parishioner? REQUIRED Please fill out this field.
  
  EMERGENCY CONTACT during retreat
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Number of Teens REQUIRED Please fill out this field.
  
  Teen 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Sex as Indicated on Birth Certificate REQUIRED Please fill out this field.
  
  Grade Level in the Fall REQUIRED Please fill out this field.
  
  T-Shirt Size (Adult) REQUIRED Please fill out this field.
  
  Do you currently have a Holy Rosary T-Shirt? REQUIRED Please fill out this field.
  
  Roommate Request? Please enter valid data.
  
  VIDEO/PHOTOGRAPHY CONSENT: REQUIRED Please fill out this field.
  
  My son/daughter has had an episode of the following or has been diagnosed REQUIRED Please fill out this field.
  
  Allergic Reactions to the following: Please enter valid data.
  
  Has had medical surgery in the last 6 months? REQUIRED Please fill out this field.
  
  Surgery Details: Please enter valid data.
  
  Medically Prescribed Diet (please describe):
  
  The following Physical Limitations:
  
  Immunizations Up to Date? REQUIRED Please fill out this field.
  
  Date of Last Tetanus/Diphtheria Immunization? REQUIRED Please fill out this field. Please enter valid data.
  
  Teen Participation Agreement
  
  In checking the box below I agree to abide by any/all policies and rules established for this event. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent's expense.
  
  I Agree Please select this field.
  
  Teen 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Sex as Indicated on Birth Certificate REQUIRED Please fill out this field.
  
  Grade Level in the Fall REQUIRED Please fill out this field.
  
  T-Shirt Size (Adult) REQUIRED Please fill out this field.
  
  Do you currently have a Holy Rosary T-Shirt? REQUIRED Please fill out this field.
  
  Roommate Request? Please enter valid data.
  
  VIDEO/PHOTOGRAPHY CONSENT: REQUIRED Please fill out this field.
  
  My son/daughter has had an episode of the following or has been diagnosed REQUIRED Please fill out this field.
  
  Allergic Reactions to the following: Please enter valid data.
  
  Has had medical surgery in the last 6 months? REQUIRED Please fill out this field.
  
  Surgery Details: Please enter valid data.
  
  Medically Prescribed Diet (please describe):
  
  The following Physical Limitations:
  
  Immunizations Up to Date? REQUIRED Please fill out this field.
  
  Date of Last Tetanus/Diphtheria Immunization? REQUIRED Please fill out this field. Please enter valid data.
  
  Teen Participation Agreement
  
  In checking the box below I agree to abide by any/all policies and rules established for this event. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent's expense.
  
  I Agree Please select this field.
  
  Teen 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Sex as Indicated on Birth Certificate REQUIRED Please fill out this field.
  
  Grade Level in the Fall REQUIRED Please fill out this field.
  
  T-Shirt Size (Adult) REQUIRED Please fill out this field.
  
  Do you currently have a Holy Rosary T-Shirt? REQUIRED Please fill out this field.
  
  Roommate Request? Please enter valid data.
  
  VIDEO/PHOTOGRAPHY CONSENT: REQUIRED Please fill out this field.
  
  My son/daughter has had an episode of the following or has been diagnosed REQUIRED Please fill out this field.
  
  Allergic Reactions to the following: Please enter valid data.
  
  Has had medical surgery in the last 6 months? REQUIRED Please fill out this field.
  
  Surgery Details: Please enter valid data.
  
  Medically Prescribed Diet (please describe):
  
  The following Physical Limitations:
  
  Immunizations Up to Date? REQUIRED Please fill out this field.
  
  Date of Last Tetanus/Diphtheria Immunization? REQUIRED Please fill out this field. Please enter valid data.
  
  Teen Participation Agreement
  
  In checking the box below I agree to abide by any/all policies and rules established for this event. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent's expense.
  
  I Agree Please select this field.
  
  Teen 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Sex as Indicated on Birth Certificate REQUIRED Please fill out this field.
  
  Grade Level in the Fall REQUIRED Please fill out this field.
  
  T-Shirt Size (Adult) REQUIRED Please fill out this field.
  
  Do you currently have a Holy Rosary T-Shirt? REQUIRED Please fill out this field.
  
  Roommate Request? Please enter valid data.
  
  VIDEO/PHOTOGRAPHY CONSENT: REQUIRED Please fill out this field.
  
  My son/daughter has had an episode of the following or has been diagnosed REQUIRED Please fill out this field.
  
  Allergic Reactions to the following: Please enter valid data.
  
  Has had medical surgery in the last 6 months? REQUIRED Please fill out this field.
  
  Surgery Details: Please enter valid data.
  
  Medically Prescribed Diet (please describe):
  
  The following Physical Limitations:
  
  Immunizations Up to Date? REQUIRED Please fill out this field.
  
  Date of Last Tetanus/Diphtheria Immunization? REQUIRED Please fill out this field. Please enter valid data.
  
  Teen Participation Agreement
  
  In checking the box below I agree to abide by any/all policies and rules established for this event. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent's expense.
  
  I Agree Please select this field.
  
  Teen 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Sex as Indicated on Birth Certificate REQUIRED Please fill out this field.
  
  Grade Level in the Fall REQUIRED Please fill out this field.
  
  T-Shirt Size (Adult) REQUIRED Please fill out this field.
  
  Do you currently have a Holy Rosary T-Shirt? REQUIRED Please fill out this field.
  
  Roommate Request? Please enter valid data.
  
  VIDEO/PHOTOGRAPHY CONSENT: REQUIRED Please fill out this field.
  
  My son/daughter has had an episode of the following or has been diagnosed REQUIRED Please fill out this field.
  
  Allergic Reactions to the following: Please enter valid data.
  
  Has had medical surgery in the last 6 months? REQUIRED Please fill out this field.
  
  Surgery Details: Please enter valid data.
  
  Medically Prescribed Diet (please describe):
  
  The following Physical Limitations:
  
  Immunizations Up to Date? REQUIRED Please fill out this field.
  
  Date of Last Tetanus/Diphtheria Immunization? REQUIRED Please fill out this field. Please enter valid data.
  
  Teen Participation Agreement
  
  In checking the box below I agree to abide by any/all policies and rules established for this event. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent's expense.
  
  I Agree Please select this field.
  
  Who is allowed to drop off/pick up the teen(s) before and after the retreat? REQUIRED Please fill out this field.
  
  Parent Agreement
  
  Note: If someone tries to pick up the teen and is not on this list we will not release the teen to said person. We will notify you and ask for your permission before releasing the teen to anyone not included on this list.
  
  I understand that if my child will be driving home without adult supervision, Holy Rosary is not responsible for my teen once the retreat has ended and my child has left the property
  I Agree Please select this field.
  
  MEDICAL INFORMATION
  
  Doctor's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Doctor's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Company REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Group Number REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/Guardian Electronic Signature REQUIRED Please fill out this field. Please enter valid data.
  
  In the event of an emergency, I hereby give permission to the staff and volunteers of Holy Rosary Catholic Church to seek emergency medical transport and/or treatment for my child(ren) named above. I will be responsible for all costs incurred. I wish to be advised before further care is given by the hospital or doctor.
  I Agree Please select this field.
  
  Please list all Medications/Allergies/Special Health Information including Anxiety, Depression, ADHD, or other needs
  
  My child will bring the following necessary medications, well labeled. Names of medications and concise directions for seeing that the child takes such medications, including DOSAGE and FREQUENCY are as follows:
  
  Please select one: REQUIRED Please fill out this field.
  
  I grant permission for the following nonprescription medication to be given to my child:
  
  Tylenol/Acet. REQUIRED Please fill out this field.
  
  Throat Lozenge: REQUIRED Please fill out this field.
  
  Antacid REQUIRED Please fill out this field.
  
  Advil/Ibuprofen REQUIRED Please fill out this field.
  
  Decongestant REQUIRED Please fill out this field.
  
  Antihistamine REQUIRED Please fill out this field.
  
  Sunscreen REQUIRED Please fill out this field.
  
  Bug Spray REQUIRED Please fill out this field.
  
  Submit
  
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- Ready to Make a Payment?
  
  Use our online payment system or drop off a Check or Cash anytime to the front office. Make sure you clearly label your envelope with your teen's name and address to Rebecca Wolfgang or Youth Ministry AYC.
  
  Paying Online - use the One Time Gift option and MAKE SURE to put AYC Payment in the Memo, along with your TEEN's NAME.
- Make an Online Payment

HOLY ROSARY PARISH

HOLY ROSARY CATHOLIC CHURCH & SCHOOL | ST. WENCESLAUS MISSION

AYC 2022

REGISTER TODAY!

More Information...

Join us July 29-31, 2022 for the Archdiocesan Youth Conference here in Houston Texas!

Registration summary

Archdiocesan Registration for AYC

Holy Rosary AYC Registration - to be completed AFTER registering above.

PARENT/GUARDIAN 1

PARENT/GUARDIAN 2

EMERGENCY CONTACT during retreat

Teen Participation Agreement

Teen Participation Agreement

Teen Participation Agreement

Teen Participation Agreement

Teen Participation Agreement

Parent Agreement

MEDICAL INFORMATION

Ready to Make a Payment?