Archdiocese of Dubuque - TEC #592 - Wahlert High School, Dubuque

Participant First Name REQUIRED Please fill out this field. Please enter valid data.

Participant Last Name REQUIRED Please fill out this field. Please enter valid data.

Birthdate REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Please fill out this field.

Participant Email REQUIRED Please fill out this field. Please enter valid data.

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.

Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Select your school from the list below REQUIRED Please fill out this field.

Select Grade REQUIRED Please fill out this field.

Parish REQUIRED Please fill out this field.

Family Information

Information including confirmation emails and other TEC information will be sent to the participant's email and copied only to the first parent/guardian listed. Parent/Guarding 1 will be required to complete a liability form and make payment in order for this registration to be complete.

Parent/Guardian 1 First Name REQUIRED Please fill out this field. Please enter valid data.

Parent/Guardian 1 Last Name REQUIRED Please fill out this field. Please enter valid data.

Parent/Guardian 1 Cell Phone REQUIRED Please fill out this field. Please enter an integer (number).

Parent/Guardian 1 Email REQUIRED Please fill out this field. Please enter an email address.

Parent/Guardian 2 First Name Please enter valid data.

Parent/Guardian 2 Last Name Please enter valid data.

Parent/Guardian 2 Cell Phone Please enter an integer (number).

Parent/Guardian 2 Email Please enter an email address.

TEC Questions

The following questions are to help the TEC team know a little about who is coming prior to the TEC weekend so they can form small groups that make TEC best for everyone. These questions are personal and should be completed honestly by the TEC participant.

What are your interests and hobbies?

What school activities and organizations are you involved in? Please enter valid data.

What do you feel are your special gifts/talents?

Previous Experiences

We want to know about any previous experiences you have had so we can make TEC the best experiene for you. Please check "Yes" if you have ever experienced one of the faith forming experiences below.

Catholic School (any grade) Yes No

Parish Religious Education (any grade) Yes No

Helped as a leader for Vacation Bible School (VBS) Yes No

Service Trip (like Catholic Heart Work Camp) Yes No

NCYC Yes No

Steubenville Conference Yes No

Confirmation Preparation Program Yes No

Other Youth Ministry Events Yes No

More About You...

Why do you want to go on TEC?

What are your expectations of the TEC weekend?

Do you see yourself as a Leader? Why? Why not?

Personality Type

The following questions are about how you would describe yourself. Please check "Yes" if you believe the following words describe you. Would you describe yourself as....

shy or timid? Yes No

Humorist or Witty? Yes No

Silent or Peaceful? Yes No

Frank or Opinionated? Yes No

Pioneer or Leader Yes No

Supporter or Follower Yes No

How would you rate your interest in religious faith, on a scale of 1-10 (1 not so much/10 very much)? Please enter an integer (number) from 0 to 10.

Is there anything going on in your life that you would like us to know about (ex. joyful, tragedy, special needs)?

TEC Participant Expectations
1. I recognize that TEC is a religious retreat.
2. It is my personal choice to make a TEC weekend.
3. I will be present at TEC from 10 a.m. on Friday or Saturday until the closing at 4 p.m. on Sunday or Monday depending on the TEC.
4. I am aware that I may be in photos or video during this event and I hereby consent to use of these materials for youth ministry publicity or promotion.
5. I will not bring alcohol, tobacco products, or drugs (except as prescribed by a doctor).
6. I will not bring any obscene or offensive materials of any kind to the retreat.
7. I will not bring books, homework, or electronics (laptop, ipod, video games, etc.) of any kind.
8. Your photo and personal contact information may be shared with others on TEC to allow for follow-up communications and publicity. If you wish to keep your information/photo confidential, please notify the Office of Adolescent Faith Formation.