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Candidate Application for Youth Encounter Retreat #108: November 10-12, 2023

- Candidates must be at least 16 years old or in the 2nd semester of their Sophomore year of high school.
  
  Each candidate needs a sponsor to attend. If you do not have one, apply anyway and we'll find a sponsor for you.
  
  Who can sponsor you?
  
  Another young person who made a Youth Encounter
  
  An adult who made a Cursillo weekend
  
  A priest or religious who knows you well.
  
  (a parent cannot be your sponsor)
  
  Your Sponsor will assist you in getting a ride to Fortune Lake and will answer any questions you have.
  
  Visit the FAQ page for answers to common questions.
  
  All information submitted will be kept confidential.
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Candidate Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Year in high school or college REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address 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.
  
  Area REQUIRED Please fill out this field.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Your Email REQUIRED Please fill out this field. Please enter an email address.
  
  Gender REQUIRED Please fill out this field.
  
  Candidate's Sponsor
  
  I know who my sponsor will be REQUIRED Yes No Please fill out this field.
  
  My Sponsor's Name Please enter valid data.
  
  Sponsor's Phone Number Maximum 20 characters Please enter a phone number.
  
  Sponsor's Email Please enter an email address.
  
  Candidate's Mother Contact Info
  
  Mother's Name (or legal guardian) REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address (if different from yours) Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Candidate's Father Contact Info
  
  Fathers' Name (or legal guardian) REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Street Address (if different from yours) Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Data for the Weekend
  
  Why do you want to attend a Youth Encounter weekend?
  
  Do you have any food allergies? REQUIRED
  We request food allergy information so that Fortune Lake Staff can be made aware of any special dietary needs.
  Please fill out this field.
  
  If yes, what are they? Please enter valid data.
  
  Are you taking any medications? REQUIRED Please fill out this field.
  
  If yes, which ones?
  
  Emergency Contact
  
  Emergency contact person (other than parent/guardian) Please enter valid data.
  
  Emergency contact phone Maximum 20 characters Please enter a phone number.
  
  Submit
  
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