2027 - Youth Retreat Registration

St. Jude Syro Malabar Catholic Church of Northern Virginia

cordially invites all

College Students and Young Adults to participate in:
RENEW 2.0

Youth Retreat Registration
Dates:

January 8, 2027 (Friday)

2 PM onwards

January 10, 2027 (Sunday)

until 3 PM

Venue:

St. Jude Syro Malabar Catholic Church

4219 Lafayette Center Dr., Chantilly, Virginia 20151
Retreat Speakers:
- Fr. Joby Joseph
- Fr. Gregory Pine, OP
- Conal Hughes
- Simi Sahu
- Accommodation can be provided for out of town participants, if requested at the time of registration.
- Transportation from and to Dulles International Airport (IAD) will be provided if requested at the time of registration.
For registration and more details, please contact:
- Joel Jilson - (571) 442-0823
- Ajay Kanjoor - (703) 814-0850
Registration Fee:
Registration Due Date is

Nov 29, 2026
How many participants are you registering?
Total Fees to be paid:
Participant Information
Participant 1 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 2 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 3 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 4 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 5 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 6 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 7 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 8 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish)
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 9 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Participant 10 Information
Full Name

First NameLast Name
Age in Years
Enter a number > 18
Gender
Email id
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parish
Please enter your Parish name
State
Please enter the State of your Home Parish
Medical or other information we may need to know about the Participant (including food allergies, special needs etc.).
Do you need Accommodation ?
Do you need Airport pickup & drop? (Note that pickup is provided only from IAD Dulles International Airport - Organizing team will contact you once registration closes to get the Flight details) ?
Expected Arrival Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Arrival, can be updated once travel plans are confirmed
Expected Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearProvide the tentative date of Departure, can be updated once travel plans are confirmed
Emergency Contact Information

Provide at least 1 Emergency Contact
Emergency Contact 1

First NameLast Name
Emergency Contact 1 Phone Number
Format: (000) 000-0000.
Relationship
(Please enter Parent, Family Friend, Friend etc.)
Emergency Contact 2

First NameLast Name
Emergency Contact 2 Phone Number
Format: (000) 000-0000.
Relationship
(Please enter Parent, Family Friend, Friend etc.)
A Letter to your Future Self (Optional)

Take a few minutes to write a letter to the person you'll be after RENEW 2.0. We'll send it back to you after the retreat. Each participant can write their own using the link below.

https://forms.gle/BRwyjWerVikmpwmF8
Waivers & Release of Liabilities
I am attending this retreat of my own free will, without inducement or duress, and agree to abide by all guidelines provided by the organizers.
I agree to hold harmless and release St. Jude Syro-Malabar Catholic Church, the Syro-Malabar Diocese of Chicago, organizers, volunteers, and all affiliated parties (“Released Parties”) from any and all claims, liabilities, or damages arising from my participation. This release includes, but is not limited to; any theft, loss, disappearance of property, bodily injury (fatal or non-fatal) or property damage. This release applies regardless of when, where, or how claims arise, including those caused by negligence of the Released Parties.
I willingly accept all risks, known and unknown, associated with participating in retreat activities, including parking, shuttle, and/or other transportation services arranged by Released Parties.
I understand that by signing, I am waiving certain legal rights, and this agreement will be enforced to the maximum extent permitted by law.
Permissions / Consents
I consent to the use of the contact information provided during registration for retreat-related communications by the Released Parties.
I grant permission to the organizers to capture and use photos and videos taken during the retreat for purposes including, but not limited to Educational materials, Social media platforms, Church/retreat websites, Press releases.
Acknowledgement
I have read and understood all content in the above document and hereby certify that all of the information provided in this registration form is correct, accurate and complete to the best of my knowledge.
Signature
Signature

Submission
Should be Empty: