Youth Ministry Faith Food Fun 2021

: Faith, Food, Fun Summer 2021 Youth Ministry Registration/Permission
: TYPE OF EVENT: Faith, Food, Fun Youth Ministry Activities Summer 2021 Program

TIMES: 6:30 pm to 9:00pm

DATES/LOCATIONS: "meet at" location set up each month
- Wed June 30th -- meet at Belle Creek Roller rink
- Wed July 28th -- location to be determined
- Wed August 25th -- location to be determined

INDIVIDUAL(S)/TEACHER(s) IN CHARGE: Cindy Meyers, Matt Belford and other chaperones as needed.

MODE OF TRANSPORTATION TO/FROM EVENT: Meet at the lcoation- no transportation provided

OTHER INFORMATION:: none

BY CHECKING THE BOX - I GIVE MY CHILD/CHILDREN PERMISSION
to participate in the above named activities and I warrant that my child is in good health. In consideration of my child’s participation, I agree to indemnify the Church of St. Joseph and the Archdiocese of St. Paul & Minneapolis from any claims or law suits brought against the Church of St. Joseph/Archdiocese of St. Paul & Minneapolis by myself, my child or others, that arises out of any behavior by my child at the event/activity described above. I also agree to pay reasonable attorney’s fees or expenses incurred by the parish/school and the Archdiocese in defense of such a claim/suit.
PERMISSION TO ATTEND: I CONSENT
EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I give permission to transport my child to a hospital for medical treatment. I wish to be advised prior to any further treatment by a doctor or hospital. In the event of any emergency, if you are unable to reach me please contact (enter name):
phone number:
NAME OF CHILD(REN) I GIVE PERMISSION TO ATTEND
St. Joseph, Miesville DISCLOSURE, AUTHORIZATION, CONSENT AND RELEASE FOR SOCIAL MEDIA OR OTHER ELECTRONIC COMMUNICATION INVOLVING MINORS I am the parent or legal guardian of the child/children listed above. I have been made aware of the St. Joseph, Miesville, acceptable Use Policy for Electronic Communications and the Social Media Policy of St. Joseph. I authorize staff or other leaders of St. Joseph to communicate with My Child electronically, including via social media, text, email and phone in accordance with the Acceptable Use Policy for Electronic Communications. Church Personnel are not required to share non-private communications, such as those sent to youth groups regarding meeting locations or times, or other administrative matters. If any staff or other leaders knowingly communicate privately with a minor as a part of his or her duties for or on behalf of St Joseph, reasonable steps must be taken to send to me the same communication content, not necessarily via the same technology. I acknowledge that to review or receive public communications shared via social media with My Child, I will need to become a fan or follower of the same social media. I understand that communications may be accessible or viewable by others who are also fans or followers of the same social media. AUTHORIZATION, CONSENT AND RELEASE FOR USE OF VISUAL LIKENESSES AND ORIGINAL WORKS OF MINORS I authorize and consent that St. Joseph Miesville and the Archdiocese of Saint Paul and Minneapolis be permitted to use and publish for general communications, advertising, commercial or publicity purposes, or for any other lawful purpose whatsoever the likeness of My Child and My Child’s original work, including video, photographic portraits, pictures, or reproductions, made through any medium, including social or other electronic media, in accordance with the Acceptable Use Policy for Electronic Communications and the Social Media Policy, provided only the first name (not the family name) is identified if any name is used. I hereby release St. Joseph, Miesville, the Archdiocese of Saint Paul and Minneapolis, and anyone authorized by St. Joseph, Miesville or Archdiocese of Saint Paul and Minneapolis with such use. This consent regarding My Child’s likeness or original work is valid for one year. If I choose to rescind my authorization and consent, I agree that I will inform St. Joseph, Miesville in writing and that my rescission will not take effect until it is received by St. Joseph, Miesville. I understand however that it may not be possible to recall any work or photos that have been published prior to receipt of my written rescission. I have read the above Disclosures, Authorizations, and Releases, have had the opportunity to consider their terms, and understand them. I execute this document voluntarily and with knowledge of its significance.: I CONSENT
I WILL REVIEW THE YOUTH CODE OF CONDUCT WITH MY CHILD/CHILDREN: • Treat all other persons with respect and not cause any intentional harm (physically, emotionally, or spiritually) to any person in any way. • Respect the property of others, including all program facilities and property. • Follow all appropriate instructions of all personnel aiding in this event, including, but not limited to chaperones, support staff, transportation personnel and administration. • Be on time for all check-ins and departure time. • Not have in my possession any tobacco, alcohol or any controlled illegal substance.: YOUTH CODE OF CONDUCT REVIEW
BY PRINTING MY NAME AND PRESSING SUBMIT, THIS SERVES AS AN ELECTRONIC SIGNATURE FOR THE ABOVE PERMISSION FORM:

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Youth Ministry Faith Food Fun 2021

Faith, Food, Fun Summer 2021 Youth Ministry Registration/Permission

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