Youth Ministry

Youth Ministry Registration Form

#1 Parent/Guardian Contact Information REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

#2 Parent/Guardian Contact Information Please enter valid data.

Email Please enter an email address.

Phone Number Please enter a phone number.

Primary Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Emergency Contact Information REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Physician Contact Information REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Liability Release: If needed, I give my permission to have my child(ren) transported by ambulance to a medical facility in the event of illness, injury or other medical emergency. If needed, I give my permission for my child(ren) to be evaluated, diagnosed, treated, and/or medicated in accordance with standard medical practice by licensed medical personnel. I relieve the Parish of all responsibility and consequences that may arise as the result of this treatment, and I will not hold the Parish, Diocese, staff, group leader or other representative responsible in the event of illness, injury or other medical emergency. Further, I agree to accept any and all financial responsibility as a result of scheduling such treatment. If I or my alternate cannot be reached in case of an emergency, I give my permission for the Parish staff, group leader or other representative to act on my behalf.

By clicking "yes," you agree to the above terms. REQUIRED Yes No Please fill out this field.

Health and Safety Release: I agree that my child(ren) will follow safety guidelines according to diocesan protocol at any church sponsored event. My child(ren) will not attend in-person meetings if she/he feels sick.

By clicking "yes," you agree to the above terms. REQUIRED Yes No Please fill out this field.

Image Release: Do you give permission to have the child(ren) listed on this form photographed or videoed at various events throughout the year? Photographs/videos may be used in publications, official websites, and official social media pages for All Saints Parish. Additional permission will be secured if including name of child(ren) or group.

By clicking "yes," you agree to the above terms. REQUIRED Yes No Please fill out this field.

Is your family registered as parishioners of All Saints Parish? REQUIRED Yes Not yet Please fill out this field.

Where does your family normally attend Mass? Our Lady Queen of Peace, Boothbay Harbor St. Patrick Church, Newcastle St. Ambrose Church, Richmond St. Mary Church, Bath St. John the Baptist Church, Brunswick St. Charles Borromeo Church, Brunswick

Is there anything we should be aware of concerning your child(ren)'s medical requirements? Allergies? REQUIRED Please fill out this field.

Youth Ministry Registration Fee REQUIRED Please fill out this field.

Online Payment of Youth Ministry Registration Fee REQUIRED 25.0 – $25 - 1 child 50.0 – $50 - 2 or more children Please fill out this field.

Youth Ministry

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Youth Ministry Registration Form

Youth Ministry at St. Charles Borromeo

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