St. Clare of Assisi Catholic Church

Houston, TX

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AYC 2023

- Faith Formation

Archdiocesan Youth Conference
Hilton Americas Hotel
July 28-30, 2023

The Archdiocesan Youth Conference (AYC) gathers participants - both youth and adults - from all over the local Church. AYC is the largest evangelizing event for older adolescents that the Office of Adolescent Catechesis and Evangelization hosts annually.

Participants will experience the diversity of the Archdiocese of Galveston-Houston! They will have the opportunity to share and deepen their relationship with Jesus Christ through daily Mass, Exposition of the Blessed Sacrament, Confession, dynamic talks, and other prayer experiences.
Registration & Cost

This year AYC costs $350 (subject to change). This includes hotel (the Hilton Americas), the conference fee, meals for the weekend, all other supplies and materials needed as well the cost of the chaperones built in. If money is an issue please contact the youth ministry office as we have scholarship money available. Money should never prevent a teen(s) from attending events.
AYC Registration Form
The maximum number of form submissions has been reached. This form is currently not available.
- Please fill out the registration form below if you are wanting to sign up for AYC 2023. Please note that unless discussed and agreed to prior, this AYC registration is ONLY for St. Clare parishioners.
- Personal 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.
- Address REQUIRED Please fill out this field. Please enter valid data.
- Address Line 2 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.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Current Grade Level or Position REQUIRED Please fill out this field.
- Adult T-Shirt Size REQUIRED Please fill out this field.
- Roommate Request (please note this is not guaranteed) Please enter valid data.
- PARTICIPANT: In signing the line 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.
- Electronic Signature of Participant REQUIRED Please fill out this field. Please enter valid data.
- Parent/Guardian 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.
- 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.
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Email Please enter an email address.
- Phone Number Maximum 20 characters Please enter a phone number.
- Emergency Contact 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.
- Emergency Contact Relationship 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.
- Insurance & Medical Information
  
  Personnel will take reasonable care to see that the following information will be held in confidence.
- Name of Doctor REQUIRED Please fill out this field. Please enter valid data.
- Doctor Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Allergies/Special Notes REQUIRED Please fill out this field.
- You should also be aware of these special medical (e.g. diabetes, heart disease, etc.) and/or psychological conditions of my child (e.g. depression, ADD, etc.):
- My child will bring all such medications, well labeled, that are necessary. Names of medications and concise directions for seeing that the child takes such medications, including dosage and frequency are as follows: Please enter valid data.
- I hereby Grant Permission for nonprescription medication (such as Tylenol, Benadryl, throat lozenges, cough syrup, etc.) to be administered to my child if deemed advisable. REQUIRED Please fill out this field.
- Initial REQUIRED Please fill out this field. Please enter valid data.
- Do you/your child have medical insurance coverage at this time? REQUIRED Please fill out this field.
- Insurance Carrier Please enter valid data.
- Name of Insured Please enter valid data.
- Insurance ID Please enter valid data.
- Insurance Group Number Please enter valid data.
- Consent & Liability Waivers
- Consent and Liability Waiver
  I grant my permission for me/my child(ren) to participate in AYC. 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, St. Clare of Assisi Catholic Church (its pastor and other agents etc.) or any other representatives associated with the scheduled activity, unless the parties involved were careless.
  I Agree Please select this field.
- Medical Waiver
  I hereby warrant to the best of my knowledge, me/my child(ren) is/are in good health, and I assume all responsibility for the health of my child. In case of an emergency and I cannot be reached, please contact the emergency contact listed above. In the event of an emergency, I hereby give permission to the staff of St. Clare of Assisi Catholic Church and the Archdiocese of Galveston-Houston 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.
- Video & Photography Consent
  As a parent/guardian, I understand that promotional pictures and videos (individual and group) may be taken during AYC. I give permission for me/my child(ren)'s pictures (named above) to be used for church promotional materials such as newsletters, web pages, social media, calendars, Power Point presentations, or videos to promote or highlight activities of the children participating in AYC.
  I Agree Please select this field.
- Electronic Signature REQUIRED Please fill out this field. Please enter valid data.
Submit

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AYC 2023

Personal Information

Parent/Guardian Information

Emergency Contact Information

Insurance & Medical Information

Consent & Liability Waivers