“Ecce Ancilla Domini ~ Behold the Handmaid of the Lord”

DIOCESE OF ARLINGTON
“Ecce Ancilla Domini ~ Behold the Handmaid of the Lord”
Luke 1:38
WHO:
High School Young Women
WHERE:
(On May 30th any available spots will
be opened for rising 9th graders.)
Mount St. Mary’s Seminary
Emmitsburg, MD
WHEN:
FEE:
Sunday, July 10 to
Wednesday, July 13, 2011
$75, assistance avaiable
FIAT is Latin for 'Let it be done'. It was Mary's response to the angel Gabriel
when she was asked to become the mother of Jesus. 'The FIAT DAYS camp
is for young women in high school who want to grow in faithful discipleship
by modeling their personal holiness on that of our Lady. By doing so they
hope to be better able to discover their own vocation invitation from our
Lord, whatever that might be and make their own "fiat" or "yes" to Him.
Contact Father Brian Bashista, Director of Vocations
(703) 841-2514 ~ [email protected]
www.arlingtonvocations.org
July 10 (2:30pm)July 13 (1:30pm), 2011
“Ecce Ancilla Domini.”
“Behold the Handmaid of the Lord.”
Mount St. Mary’s Seminary
16300 Old Emmitsburg Road
Emmitsburg, MD 21727
(301) 447-5330
FIAT DAYS
2011
Registration
Fr. Brian Bashista
Vocations Director
200 N. Glebe Road; Suite 901
Arlington, VA 22203
(703) 841-2514
www.arlingtonvocations.org
[email protected]
---------------------------------------------------------------------(Please Print)
Name:
Phone:
Cell:
Address:
City
State
Zip
School/Current Grade 2010-2011:
E-mail Address:
Parish:
How did you hear of FIAT Days?
Age:
Birth Date:
T-Shirt Size: (S, M, L, XL, XXL)
Participants are advised that photograph or videotape of participants may be used in publications, websites
or other materials produced from time to time by the Office of Vocations or the Diocese of Arlington.
Participants would not be identified, however, without specific written consent. Participants who do not
wish to be photographed or filmed need to notify the Office in writing. Please note that the Office has no
control over the use of photographs or film taken by media that may be covering the event in which you
participated.
Signature
Date
Emergency Contact:
Name and Relationship:
Address:
City:
Home phone:
State:
Work:
Zip:
Cell:
The cost of FIAT is $75.00 per person. This cost includes lodging, meals and supplies.
*If you need financial assistance, please contact Fr. Bashista.
Make checks payable to “Catholic Diocese of Arlington”. Please return Registration Form and check to:
Office of Vocations
200 N. Glebe Road; Suite 901
Arlington, VA 22203
FIAT DAYS 2011 CAMP
MOUNT ST. MARY’S SEMINARY; EMMITSBURG, MARYLAND
SUNDAY, JULY 10 (2:30PM) – WEDNESDAY, JULY 13 (1:30PM), 2011
Participant’s Name:
Phone:
Address:
City
State
Zip
Participant’s Commitment
I hereby make a personal commitment to participate fully in the FIAT DAYS 2011 CAMP and to abide by expected standards of
conduct.
Signature of Participant
Parental permission and liability release:
As parent/legal guardian of the participant named above, I (we) do hereby give my (our) permission to participate fully in the FIAT DAYS
2011 CAMP from July 10 (2:30pm) to July 13 (1:30pm), 2011. I/we do for myself/ourselves and for and on behalf of my/our child
referred to here as ‘participant’ do release, forever discharge and agree to hold harmless The Diocese of Arlington Office of Vocations, its
directors, employees, and agents thereof from any and all liability, claims, demands for personal injury, sickness and death, as well as
property damage and expenses of any nature whatsoever which may be incurred by the undersigned of the participant resulting from said
participant’s involvement in the above mentioned event (including transportation to and from the event). Furthermore, I/we on behalf of the
participant hereby assume all risk of personal injury, sickness, death, damage, and expenses resulting from said participant’s involvement
in the above described event.
Further, authorization and permission are hereby given to the Diocesan Office of Vocations, its directors, employees and agents thereof to
furnish any necessary transportation or food while the named participant is involved in the above described event.
I/we hereby authorize Reverend Brian Bashista to admit the participant to a doctor, hospital, or other licensed health care provider for
medical treatment and assume full responsibility for all costs of such treatment. Further, should it be necessary for the participant to return
home due to medical, disciplinary, or other reasons, I/we do hereby assume responsibility for the participant’s transportation home and any
costs related thereto.
Emergency Contact: Name:
Phone Number: (H)
Relationship:
(W)
(C)
Health Information: Are there any conditions or allergies which may affect the participant’s involvement in the above event?
YES
NO
If YES, please explain:
Is there any physician prescribed or other medication which the participant may be taking during the above event?
YES
NO
If YES, please provide name, dosage, and potential side effects of said medications:
Name and phone number of physician or Health/Medical Insurance:
Primary Healthcare Provider:
Insurance Company:
Phone:
Policy Number:
I/we understand and hereby agree to the terms and conditions of the participant’s involvement in the above described event.
Signature of Parent/Guardian
Daytime Phone
Please return the completed form along with the FIAT DAYS 2011 CAMP registration form & $75.00 fee to:
Office of Vocations, 200 N. Glebe Road, Suite 901, Arlington, VA 22203
Make check payable to “Catholic Diocese of Arlington”.
Please sign and send this form to: Office of Vocations / 200 N. Glebe Road; Suite 901 / Arlington, VA 22203
(or) sign this form and bring it with you to the camp and present it at the check-in desk.
Fiat Days 2011
CODE OF BEHAVIOR/HOSPITALITY GUIDELINES
We wish you an early welcome to Diocese of Arlington Fiat Days 2011 Camp! We are
confident it will be a great experience, leading you closer to Christ and having a great time
together.
Please review the following expectations:
 No one (except staff) is permitted in the kitchen area. Drinks and snacks will be
provided in the recreation room.
 Do not leave trash around the building and grounds. Any vandalism will result in
immediate dismissal from the camp.
 Stay with the group and do not roam around the building or grounds. You will have
recreational time permitted in designated areas.
 Participants are expected, health permitting, to attend all activities.
 Everyone will be assigned to a bedroom. You may not switch rooms. In case of an
emergency, it is necessary to know where each person is sleeping.
 No visiting is allowed in anyone’s bedroom.
 Only enter the bedroom corridor containing your bedroom. No one is permitted to enter
any other hallway containing bedrooms.
 Do not leave your corridor during nighttime hours.
 Alcohol, drugs or drug paraphernalia are not permitted. If this is violated, you will be
immediately dismissed from the camp.
 Treat each other with respect. Be Christ to each other.
We respectfully ask for your cooperation and are sure that you will adhere to this simple code of
behavior. You represent the Church and are called as a young woman to project an image of
Christian consideration and respect to all others and to the property around you.
I understand and agree to the Camp Code of Behavior and realize that infractions may result in my
dismissal.
_________________________________________________________________________________
Participant’s Signature
Print Name
Date
_________________________________________________________________________________
Parent’s Signature (if under 18)
Print Name
Date