Youth Group Service Project 2020
Wednesday, August 26, 2020
8am-12noon
Good Shepherd
NEEDED: 10-12 middle or high schoolers, chaperones welcome also
We will be pulling weeds and helping with landscaping/gardening on our church grounds. There will be boxed lunches and drinks. We need 10-12 young people to help out, but if we get more, we'll find a place for you to serve.
Please register here by Monday, August 24, 2020.
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Email *
FIRST AND LAST NAME OF PARTICIPANT 1 (youth or adult) *
FIRST AND LAST NAME OF PARTICIPANT 2 (youth or adult)
FIRST AND LAST NAME OF PARTICIPANT 3 (youth or adult)
FIRST AND LAST NAME OF PARTICIPANT 4 (youth or adult)
PARENT/GUARDIAN FULL NAME *
HOME ADDRESS *
ALTERNATE EMAIL ADDRESS
BEST PHONE TO CONTACT DURING EVENT *
ALTERNATE PHONE *
ALTERNATIVE CONTACT (If unable to reach you) *
ALTERNATIVE CONTACT BEST PHONE DURING EVENT *
PHYSICIAN'S FULL NAME *
PHYSICIAN'S PHONE *
NAME OF MEDICAL INSURANCE *
MEDICAL INSURANCE POLICY NUMBER *
PERTINENT MEDICAL CONDITIONS
INHALER/EPI-PEN
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ANY FOOD ALLERGIES TO BE AWARE OF? *
Indemnity Agreement and Photo Release

**In consideration for my child/ward participation, I agree to reimburse and indemnify parishes for all reasonable legal and court fees incurred by parishes in defending a lawsuit that I or my child/ward may bring against parishes, which relates to the above named activity if  is found not legally liable by the courts and prevails in the lawsuit. If the parishes are found legally liable for injuries sustained by son/daughter/ward, this paragraph will not apply. I certify that I have an understanding of this agreement and any risks and hazards associated with the activity described above that my child/ward will be participating in. I further understand that I have the opportunity to fully discuss this agreement with a representative of the parishes to clarify any concerns or questions about the activity or this agreement that I may have. As parent or guardian of the above named student, I give permission for my child to participate in the field trip described above.

 **Photo & Video Release: I hereby give my permission to the parishes for photographs and/or videos that may include my child’s image to be used in promotional materials. This includes any prints, slides, copies, reductions, or any other processes or treatments necessary to make a photograph/video for reproduction purposes. I release all rights and privileges for financial obligations for this permission.

 **In the event of an emergency, I give permission to transport my child to a hospital for emergency medical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.  
By entering my full name, I attest that this constitutes my legal electronic signature on this form. *
A copy of your responses will be emailed to the address you provided.
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