2026-2027 Kairos Journey FORM

2026-2027 Kairos Journey Retreat Form
Restart Workflow
3-Day Overnight Retreat

Location: San Damiano Retreat Center, 710 Highland Dr, Danville, CA 94526
Carondelet Student ID #
Student First Name
Student Last Name
Student's Date of Birth

MonthDayYear
Date
Student Carondelet Email
I have been assigned to: {hiddenAssigned}
I would like to:
You cannot submit this form without a "@carondeleths.org" email. Please check the "Student Carondelet Email" on the first page.

Late Date Request

Please take some time to read this carefully before signing and committing
By selecting "I Agree" below, I acknowledge that I am not currently CONFIRMED or WAITLISTED on any retreat.
Please select the date you are REQUESTING
I understand the following:
- A request to change my retreat date after the Retreat Date Change Period ends will incur a $75 fee. The deadlines for Retreat Date Change Periods are as follows:
  - Kairos 108 - Wednesday, July 1
  - Kairos 109 - Friday, August 21
  - Kairos 110 and 111 - Tuesday, December 1
I also agree to the following Late Cancellation and No-Show Policy:
- A $200 Late Cancellation Fee will apply for any cancellations made within four weeks of the retreat date, except in cases of illness or injury with medical documentation.
- If students do not show up on the day of a retreat without prior cancellation notice and medical documentation, the family will also be charged the $200 Fee.
- Registrations are non-transferable and cannot be given to another student.
Additionally:
- I am REQUESTING a date, but I am not GUARANTEED placement on the retreat roster.
- If the retreat I am requesting is full, I will be placed on a waitlist.
- Campus Ministry will contact you regarding the status of your request.
- Requests are reviewed on a first-come-first-served basis.
By signing below, I acknowledge and agree to the terms and conditions outlined in this agreement.
Late Date Request: Parent Signature
Late Date Request: Student Signature

Date Change Request
Submitting a change request forfeits my current assigned spot.

If there is no space on the requested retreat, you will be waitlisted.
Please select the date you would like to request to switch to
Please provide a reason for your date change request:
This information is required in order to review date change requests. Please be as specific as possible.
I understand the following:
- Requests will be evaluated based on availability and logistical constraints.
- Submitting a change request forfeits my current assigned spot.
- If there is no space on the requested retreat, you will be placed on a waitlist.
Approval Criteria:
- Approval is not guaranteed.
- Priority is given to requests based on academic and athletics schedules, family events, etc.
Processing Time & Change Verification:
- If a change cannot be accommodated, students will be placed on a waitlist.
By signing below, I acknowledge and agree to the terms and conditions outlined in this agreement.
Date Change Request: Parent Signature
Date Change Request: Student Signature

Emergency Information and Liability Waiver

Please provide the required information below for emergency purposes. You will receive additional retreat information via email 4-6 weeks before the retreat date. At that time, you may update or provide additional information if necessary.
Medical

Indicate your student's health considerations and some medical information below.
Carondelet staff can administer over-the-counter medications to my student if needed, including but not limited to: ibuprofen, acetaminophen, benadryl, hydrocortisone, and others).
Dietary Requests (Fill in "Vegetarian", "Vegan", "Celiac-Gluten Free" or leave blank)
Other Health considerations (limited physical activity, social/emotional health, allergies, etc.)
Epipen?
Type a question
Medical Insurance Plan and Number
Family Doctor
Doctor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Off-Campus Event Policies

A Carondelet student is expected to behave, both on and off campus, in a manner consistent with Carondelet High School’s core values. Any conduct both in and out of school that reflects negatively upon the reputation of Carondelet High School may be subject to disciplinary action, including suspension from competitive and extra-curricular activities, school suspension, and or expulsion.

Students are reminded that they are expected to adhere to the following sections of our student handbook.
- During school-sponsored events, the faculty/staff moderator is responsible for all students. The moderator determines trip guidelines including curfew, behavior expectations, meal schedules, required participation, and mandatory attendance. The trip moderator will report any violations of rules or policies to the Dean of Students and/or Assistant Dean of Students.
- Drug & Alcohol Policy: Any student found to be in possession of illegal substances, object, paraphernalia materials, items related to the use of, or productions of, illegal substances will face consequences as delineated in the student handbook.
- Harassment-Free Policy: Carondelet High School is committed to maintaining a professional and congenial learning environment that respects the dignity of each individual. The school will not tolerate any form of harassment on the basis of race, color, religion, national origin, sex, age, disability, protected activity (i.e., opposition to prohibited discrimination or participation in the statutory process) or any characteristic protected under federal, state, or local law, either in school, or at school-sponsored events/athletic competitions.
- Tech Services & Appropriate Use: Violating the privacy of individuals by recording of any kind of students, faculty, or staff without consent. Furthermore, posting these photos or recordings on social media may result in disciplinary action.
Student Signature
Student Full Name

First NameLast Name
Signature
Parent/Guardian Signee First and Last Name

First NameLast Name

Parent Contact Information
Parent/Gaurdian 1 Information
Parent/Guardian 1 First Name
Late Date Request
Parent/Guardian 1 Last Name
Parent/Guardian 1 Phone Number
Parent/Guardian 1 Phone Number - Alternate
Parent/Guardian 1 Email

Confirmation Email
Street Address Line 1
Street Address Line 2
City
Zip Code
Parent/Gaurdian 2 Information
Parent/Guardian 2 First Name
Parent/Guardian 2 Last Name
Parent/Guardian 2 Phone Number
Parent/Guardian 2 Phone Number - Alternate
Parent/Guardian 2 Email

Confirmation Email

Should be Empty:

2026-2027 Kairos Journey Retreat Form

Late Date Request

Date Change Request

Emergency Information and Liability Waiver

Parent Contact Information