St. Peter Youth Ministry Registration 2022-2023
Please fill out the form for each student you have registering for our program! Thank you!
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Student Information
Student's First Name *
Student's Last Name *
Birthday *
MM
/
DD
/
YYYY
T-Shirt Size- All adult sizes *
Current Age *
School *
Grade *
High School ONLY- What do you plan to attend? Select all the apply!
With whom does the student reside? *
If other who?
Parish- St. Peter parish membership is NOT required *
Sacraments Completed *
Required
Are you interested in sacrament preparation if needed?
Clear selection
Family Information
Mothers/Guardian Name
Father/Guardian Name
Street Address
City
Zip Code
Phone Number- this will also be the Emergency Contact *
Email Address *
Allergies/Medical Needs? *
Can we add you to our Flocknote group to receive updates, reminders and notices? *
Consent and Agreements
Consent of PARTICIPATION for Youth Ministry Activities - As a parent/guardian, by checking the box and submitting this form, I agree to release liabilities and to hold harmless St. Peter Catholic Church, its Pastors, employees, and volunteers, and the Diocese of Detroit, from and against all claims, judgments, liabilities of any nature or extent, damages, causes of action, or injuries which in any way arise out of or relate to my teen(s)’ participation in Life Teen or Edge, whether foreseen or unforeseen. *
Media Release- As a parent/guardian, by checking the box and submitting this form, I grant the Life Teen and Edge youth minister and Core Team permission to photograph/ videotape my teen during Life Teen and Edge events and for the resulting pictures & footage to be published/broadcast for the purpose of promoting the youth ministries. I understand my teen is always free to decline and my teen’s contact information will not be shared in advertising. I realize my teen may unintentionally be included in group shots, but it will be removed from promotional material at my request. If I have other preferences, I will discuss them with the youth minister and sign additional forms. *
Emergency Authorization & Release for Treatment- As parent/guardian, I attest that I have listed all pertinent medical or other conditions of my teen in this form. I acknowledge it is my responsibility to provide the youth minister with my contact information and an emergency contact authorized to make decisions for my teen in my place, and to provide adequate health insurance for my teen. In the event of an emergency, by checking this box and submitting this form, I authorize treatment of my teen by a licensed physician or adult volunteer if a physician cannot be reached, of any condition which, in the opinion of the youth minister or designated adult volunteer, is deemed necessary and appropriate for my teen. *
Please type your full name below- By typing your name, you agree to abide by the above statements and permissions. *
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