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Quinceañera Preparation

- Formation

- Contact CCE office (979-865-3432) or Cynthia Luongo (713.299.1299) one year in advance of celebration.
- Class series faciliated by bilingual team once a year, for 5 monthly sessions from October to March
- Póngase en contacto con la oficina de CCE (979-865-3432) o Cynthia Luongo 713.299.1299 un año antes de la celebración.
- Las clases son facilitadas por el equipo bilingüe una vez al año, durante 5 sesiones mensuales.
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MINI RETREAT / RETIRO de UN DÏA
Saturday, July 31st 11p-6pm

A one day retreat for students preparing for their Quince Años Celebration in fall 2021 or Spring 2022
Prayer, Discussion, Activities, Snacks and Mass.
11:00a Gather / Lunch
12:00p Topics: Background & Meaning of Quince Años, Who am I?, Who is Jesus? Women's Role in Our Society, My Youth and Values.
5:00pm - Mass together
6:00 - Close and certificate of completion.

Un día de retiro para preparar a las estudiantes que celebrarán sus 15 años para el Otoño 2021 y Primavera 2022
Clases , Oración, Actividades , Aperitivos y Misa.

11 am : Recibimiento / Comida
12 pm : Temas ; Significado de 15 años, Quien soy yo?, Quien es Jesús?, El Rol de la Mujer en Nuestra Sociedad , My Juventud y los Valores.
5 pm : Misa
6:00 pm : Termina con certificado de asistencia

FINAL DAY TO REGISTER July 20th COST $25
Mini Retreat REGISTRATION/REGISTRO para retiro de un día
The maximum number of form submissions has been reached. This form is currently not available.
- Parent Contact /información de los padres
  
  Last Name / Apellido REQUIRED Please fill out this field. Please enter valid data.
  
  Name / Nombre REQUIRED Please fill out this field. Please enter valid data.
  
  Address / Dirección REQUIRED Please fill out this field. Please enter valid data.
  
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  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 /Número telefónico REQUIRED Please fill out this field. Please enter a phone number.
  
  Preferred language /Lenguaje preferido REQUIRED Please fill out this field.
  
  Bilingual Spanish/English? No Yes
- Enter TOTAL # of retreatants you are registering /Numeró total de estudiantes que usted está registrando REQUIRED Please fill out this field.
  
  Child /Participante 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.
  
  Gender / Generó REQUIRED Please fill out this field.
  
  Date of Birth (xx/xx/xxxx) / Fecha de Nacimiento REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2021-2022 /Grado escolar 2021-2022 REQUIRED Please fill out this field.
  
  Accommodations, Support, Health, or Allergy Concerns? Alojarmientos, apoyos, necesidades de salud preocupaciónes:
  Please list any health or classroom concerns for this child.
  Please enter valid data.
  
  Child /Participante 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.
  
  Gender / Generó REQUIRED Please fill out this field.
  
  Date of Birth (xx/xx/xxxx) / Fecha de Nacimiento REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2021-2022 /Grado escolar 2021-2022 REQUIRED Please fill out this field.
  
  Accommodations, Support, Health, or Allergy Concerns? Alojarmientos, apoyos, necesidades de salud preocupaciónes:
  Please list any health or classroom concerns for this child.
  Please enter valid data.
  
  Child /Participante 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.
  
  Gender / Generó REQUIRED Please fill out this field.
  
  Date of Birth (xx/xx/xxxx) / Fecha de Nacimiento REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2021-2022 /Grado escolar 2021-2022 REQUIRED Please fill out this field.
  
  Accommodations, Support, Health, or Allergy Concerns? Alojarmientos, apoyos, necesidades de salud preocupaciónes:
  Please list any health or classroom concerns for this child.
  Please enter valid data.
  
  Child /Participante 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.
  
  Gender / Generó REQUIRED Please fill out this field.
  
  Date of Birth (xx/xx/xxxx) / Fecha de Nacimiento REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2021-2022 /Grado escolar 2021-2022 REQUIRED Please fill out this field.
  
  Accommodations, Support, Health, or Allergy Concerns? Alojarmientos, apoyos, necesidades de salud preocupaciónes:
  Please list any health or classroom concerns for this child.
  Please enter valid data.
- Emergency Contact (Not parents) / Contacto de Emergencia (NO son los padres)
  
  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 /Número telefónico REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Contact's Relation to Child(ren) / Relación del contacto de Emergencia con los Niños REQUIRED Please fill out this field. Please enter valid data.
  
  Doctor's Name / Nombre de Doctor REQUIRED Please fill out this field. Please enter valid data.
  
  Doctor's Phone Number / Número telefónico de Doctor REQUIRED Please fill out this field. Please enter a phone number.
  
  Insurance Name /Nombre de aseguranca médica REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Group Number / Número de grupo aseguranza REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Phone Number /Número telefónico de aseguranza REQUIRED Please fill out this field. Please enter a phone number.
- Medical Consent / Consentimiento Médico::
  In the event of an emergency, I hereby give permission to the staff of Industry Immaculate Conception 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.
  
  En el caso de una emergencia, doy permiso al personal de la Iglesia Católica de Immaculate Conception (Industry) para buscar transporte médico de emergencia y / o tratamiento para mi(s) hijo(s) mencionados anteriormente. Seré responsable de todos los costos incurridos. Deseo que me avisen antes de que el hospital o el médico brinde más atención.
  I Agree / Acepto Please select this field.
- Video/Photography Consent / Consentimiento de video y fotografia
  As parent/guardian, I understand that promotional pictures and videos ( individual and group) may be taken during the classes and activities. I give permission for my child(ren)'s pictures (named above) to be used for church promotional materials such as bulletins, newsletters, web pages, calendars, Power Point presentations, or videos to promote or highlight activities of the children in their Vacation Bible School activities.
  
  Como padre / tutor, entiendo que se pueden tomar fotos y videos promocionales (individuales y grupales) durante las clases y actividades. Doy permiso para que las imágenes de mis hijos (mencionadas anteriormente) se utilicen para materiales promocionales de la iglesia, como boletines, páginas web, calendarios, presentaciones en Power Point o videos para promover o realizar actividades de los niños en ICC Vacation Bible School
  I Agree / Acepto Please select this field.
- Consent and Liability Waver / Consentimiento de los Padres o Guardianes:
  
  In the event of any accident or injury, I agree on behalf of myself, my child(ren)'s other parent if known or living, the child(ren) named above or our heirs, successors, and assigns, to hold harmless and defend the Archdiocese of Galveston-Houston, its pastor or any representative of Faith Formation and Youth Ministry, unless the parties involved were careless and negligent. Effective for all Faith Formation and Youth Ministry activities at Industry Immactulate Conception Catholic Church.
  
  En caso de accidente o lesión, acepto en mi nombre, el otro padres de mi hijo (s) si es conocido o vivo, el hijo(s) mencionado anteriormente o nuestros herederos, sucesores y asigna, para mantener indemne y defender a la Arquidiócesis de Galveston-Houston, su pastor o cualquier representante de la Formación de Fe o el Ministerio Juvenil, a menos que las partes involucradas fueran descuidadas y negligentes. Efectivo para todas las actividades de Formación de Fe y Ministerio de Jóvenes en Iglesia Católica de Immaculate Conception (Industry)
  I Agree / Acepto Please select this field.
- Additional information / Información adicional Please enter valid data.
- Parent / Guardian Electronic Signature -Firma electónica de padre/guardian REQUIRED Please fill out this field. Please enter valid data.
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Quinceañera Preparation

FINAL DAY TO REGISTER July 20th COST $25