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3rd Hispanic Conference Registration

"It was not you who chose me, but I who chose you and appointed you to go and bear fruit that will remain, so that whatever you ask the Father in my name he may give you" John 15:16
- Registration
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Family/Individual Registration
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  2nd Adult Registration (spouse, friend, etc.)
  
  First Name of Second Adult (optional) Please enter valid data.
  
  Last Name of Second Adult (Optional) Please enter valid data.
  
  Emergency Contact
  
  *Preferably someone who is not with you at the conference.
  
  First and Last name of Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Relation of Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number of Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Parish info
  
  Choose your parish (or religious order). The parishes are arranged alphabetically by city. If you are not from the Diocese of Victoria, please choose "Other Diocese" REQUIRED Please fill out this field.
  
  Special Diet
  
  Choose which applies to you Vegetarian Gluten Free
  
  Only fill out for Child Care/Daycare**
  
  Please indicate if you will have children accompanying you to participate in the conference who need child care (ages 3 to 12) REQUIRED Yes No Please fill out this field.
  
  List names and ages of the minors (3 to 12 years) who will accompany you: Please enter valid data.
  
  Note:
  Children from 0 to 2 years old may be at the conference with their parents/guardians.
  Childcare will be offered for children ages 3 to 12 (children must be potty-trained).
  Youth ages 13 and older may attend the conference under the exclusive supervision of their parents/guardians and may not be left unattended at any time during the conference. Additionally, a child care consent form must be completed and signed by parents/guardians for compliance with the Diocese of Victoria Safe Environment.
  
  Agree Please select this field.
  
  Conference Registration amount per person REQUIRED Please fill out this field.
  
  Financial Assistance
  ** If you need financial assistance, please contact Aldo Camacho at the Office of Hispanic Ministry at the following email: acamacho@victoriadiocese.org or by phone 361-573-0828 x 2227 before submitting your registration form.
  
  Registration for Minors (ages 13 to 17)
  
  Please indicate if minors will accompany you to participate in the conference (ages 13 to 17) REQUIRED Yes No Please fill out this field.
  
  Please list the name(s) of the youth who will accompany you
  
  The cost of the conference is $45 per person, $10 for each youth from 13 to 17 years old and no charge for up to two children from ages 3 to 12 years old, after two children the cost is $5.00 for each additional child.
  
  Conference Childcare Registration amount for ages 3 to 12
  
  Conference Registration amount for youth ages 13 to 17
  
  If you wish to make a donation to the conference, input the amount here. $ Please enter a positive decimal.
  
  Comments Please enter valid data.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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- Pre-order the official shirt
- T-shirt Detail
- Contact Us
  
  Aldo Camacho
  
  Director of Hispanic Ministry
  
  361-573-0828 x 2227
  acamachovictoriadiocese.org
  
  Bianca Estrada
  
  Administrative Assistant to the Office of Evangelization and Catechesis
  
  361-573-0828 x 2246
  bestradavictoriadiocese.org