We are so glad you are considering participating in the upcoming TEC weekend.
TEC stands for Teens Encounter Christ. It is a powerful three-day weekend experience designed for young men and women ages 16-20. As a TEC participant, you will experience a new atmosphere away from home and school. It is a place to meet other youth from around the region, reflect on life and your ideals together, find God’s presence in your life, and have fun. TEC is a national movement that has the power to change your life!
Be prepared to encounter God in a life-altering experience.
The weekend begins Saturday at 10 a.m. and ends
Monday by 5:30 p.m. Participants are expected to stay for an entire weekend. Upcoming weekends are scheduled as outlined below:
• Sunflower TEC 237 November 10-12, 2012
Prairie Star Ranch- Williamsburg, KS
• Sunflower TEC 238 January 19-21, 2013
Savior Pastoral Center-Kansas City, KS
• Sunflower TEC 239 March 9-11, 2013
Prairie Star Ranch Williamsburg, KS
The cost for the weekend is $110. This fee includes all meals, lodging and t-shirt. If you would like to attend TEC and this cost would be a financial burden to your family, financial aid is available. Please fill out a scholarship form found on the website at www.archkck.org
. In addition, donations to this fund may be made along with your payment if you wish to help another. TEC is supported by the Archbishop’s Call to Share and your generous donations.
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Fill out the candidate information on the attached TEC application.
Have your parents fill out and sign the appropriate portions of the application also.
Include a copy of medical insurance card.
Make checks payable to TEC.
Mail the form, insurance card copy, payment, and/or scholarship application to the address indicated on the application.
 Give the Candidate Reference Form to an adult that knows you well. (It is appropriate to provide a stamped, self-addressed envelope so they can mail in the reference form.)
 To secure a sure spot on the weekend, registration should be received two weeks before retreat.
When you turn in your registration form, a confirmation letter will be mailed to you describing what to pack and directions to your TEC location.
Contact us! Rick Cheek: 913-647-0351, tec@archkck.org
or go to the TEC website www.sunflowertec.org
and it will direct you to more info and forms.

Date of TEC: ________________, to be held at: _______________________
Amount enclosed: _________ Check #_______; Cash _____; Other ___________________
Please print clearly. Fill out and return to:
TEC; Archdiocese of Kansas City in KS; 12615 Parallel Parkway; Kansas City, KS 66109
Candidate Information
Candidate Name: _______________________________________ Birthdate & Age: __________________ Year in School: _____
Candidate Address: ______________________________________City/State/Zip: _____________________________________
T-Shirt Size________ Candidate Email: ____________________________________________ Phone: _____________________
School Attending: _____________________________ Parish: __________________________ Catholic: ____ NonCatholic: ____
Confirmation Patron Saint: ______________________________________________________ Not Yet Confirmed: ____________
List anyone you know attending this TEC weekend: _______________________________________________________________
Why do you want to attend
TEC?___________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
CANDIDATE SIGNATURE: ___________________________________________ Date:____________________________
Photo Release
I hereby authorize the Archdiocese of Kansas City in Kansas, and its agents to utilize my or my child’s photographic image for the specific purpose of publication of the Archdiocese of Kansas City in Kansas events, including promotional materials. In giving my consent, I hereby release and hold harmless the
Archdiocese of Kansas City in Kansas and its agents from any and all responsibility or liability. Should any photograph of me or my child be used, I understand that I will receive no compensation.
Adult Candidate or Parent Signature: ____________________________________ Date: ___________________________
Parent Information
Mother’s Name: _______________________________________ Email: ______________________________________________
Phone: _____________________ Address (if different from candidate): _______________________________________________
Father’s Name: _______________________________________ Email: ______________________________________________
Phone: _____________________ Address (if different from candidate): _______________________________________________
Payment Rec’d: ck _______ cash ___ Other ___________________________
Candidate Confirmation Sent: Email_____ Snail Mail _____ Date_______________
Parent Confirmation Sent: Email_____ Snail Mail _____ Date_______________
Notes: initials

Parental Consent & Emergency Information
I request and give permission for my son/daughter, to participate in the TEC weekend to be held at:
______________ on: ____________________. In the event of sickness or accident, the adults supervising the retreat have my permission to secure medical care for my child. I hereby release the
Archdiocese of Kansas City in Kansas and all sponsors, chaperones, aides and others connected with the
TEC weekend from any and all claims arising out of or from any accident or other occurrence, causing injury to any person or property during this event. I also understand that in the event my child is dismissed from this event for any reason, I am responsible for his/her transportation home. I hereby warrant that, to the best of my knowledge, my child is in good health, and I assume all responsibility for his/her health.
In case of an emergency contact: ______________________________ Phone: _____________
Relationship to Candidate:_________________
Primary Medical Insurance Card Holder Name: _______________________________________
Medical Insurance Company: _________________________________ Phone : _____________
Policy Number: ________________________________________________________________
Physician’s Name: __________________________________________ Phone: _____________
Below are medications Candidate may be taking:
Medication: Dosage: Reason:
_________________________ ______________________________ __________________________________
_________________________ ______________________________ __________________________________
_________________________ ______________________________ __________________________________
_________________________ ______________________________ __________________________________
_________________________ ______________________________ __________________________________
_________________________ ______________________________ __________________________________
Please list any special medical or emotional concerns, conditions, or information such as allergies, physical limitations, homesickness, reasonable accommodations, etc., that would be helpful for the adults directing the retreat. Include all prescription medications candidate will bring to TEC, along with dosage instructions.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Candidate may be given over-the-counter medications such as:
Advil (or generic Ibuprofen)
Tylenol (or generic Acetaminophen)
Pepto Bismol
Tums/Rolaids
Other:______________________________________________________________
NO MEDICATION MAY BE GIVEN UNLESS EMERGENCY TREATMENT IS REQUIRED.
Adult Candidate or Parent Signature: ________________________________ Date: ___________________
This form has been given to you by a young person applying to attend a TEC (Teens Encounter Christ) weekend retreat. The ideal reference person is an adult, at least 21 years of age, who knows the

candidate well, but is not his/her parent. TEC is a Catholic program that provides an experience in
Christian living. Because the success of TEC depends on one’s personal commitment to the process, it is important that a candidate not be forced to participate. TEC educates, inspires and motivates young people to grow in their faith, but the ultimate decision to attend should be left to the individual without undue pressure.
Name of Candidate: ______________________________________________________________________________________
Your Name: ________________________________________________________ Phone: ______________________________
Please answer the following questions as honestly as possible.
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My acquaintance with this young person is: distant teacher/student average close
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Exercise of leadership in this young person is:
1 2 3 4 5
(none) (average) (strong)
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The maturity level of this young person is:
1 2 3 4 5
(none) (average) (strong)
This young person’s ability to meaningfully participate in a discussion group is:
(none)
1 2 3 4 5
(average) (strong)
❖ What best describes this young person’s attitude toward religion, Church and his/her faith journey?
Circle all that apply.
Antagonistic Indifferent Confused Searching Positive Leader Involved
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Other comments:
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