Sign up & Permission Form
St. Mildred Middle and High School Summer Youth Ministry Program
Online at Home

9 Weeks
Sundays from 6:30-8:30pm
June 14 - August 16, 2020

Project YM/Alpha Youth and Online video meeting (either Zoom or Google Meet, etc..)

Please include the best email to help your youth access the links for the event.
Youth Name *
Youth Date of Birth *
MM
/
DD
/
YYYY
Youth's Grade Fall 2020 *
School *
Youth Email
Address *
Parent Phone number *
Parent Email *
Father/Guardian's Name *
Mother/Guardian's Name *
Permissions
My child must comply with (entity name)Diocese of Raleigh and St. Mildred rules and procedures. By granting this permission, I also waive any claims against, and RELEASE AND HOLD HARMLESS AND INDEMNIFY, St. Mildred Catholic Church, the Diocese of Raleigh, any of their religious, employees, volunteers, agents and representatives from any liability, claims, demands and causes of action arising out of or relating to any loss, damage or injury sustained in connection with or arising out of my child’s participation in the program.


Parent/Guardian's Signature *
Participant's Agreement
Participant: In signing the line below, I agree to abide by any/all policies established for this event/activity. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand there will be consequences for my actions, including being removed from the activity.
Participant's Signature *
Consent for Communications and Social Media
In order to ensure utmost transparency and parental involvement, the Diocese of Raleigh has created this consent form so that parents and guardians may select how ministry leaders communicate electronically with minors. Any and all digital networking and communication including but not limited to, email, texting, Facebook, Twitter, other Social Networking sites, etc., with parish youth/school/organization will be ministry related and NOT personal in nature, restricted to matter concerning classes, youth ministry events, parish events, school events, athletic/event schedule or registration forms. This form will be filed in a confidential folder for parish/school/organizational use only. The person(s) being authorized to communicate with the minor child is in compliance with all safe environment policies of the Diocese of Raleigh.
Parent Approved Electronic Communication Types *
Required
Please list approved electronic communication addresses *
Youth Approved Electronic Communication Types *
Required
Please list approved electronic communication addresses *
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