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FIRST NAME______________________________Last Name______________________________GRADE

ADDRESS_________________________________________________________ZIP_______________ Birthday___________ PHONE: Home:________________________________ Mass?:____________________ EMAIL used for updates: Students Email_______________________________________________________________________ Parents Email ___________________________________________________________________________ Parental Information: Mother: ________________________________________ Phone to use: __________________________________ Father:_________________________________________ Phone to use: __________________________________ Sacraments Completed: Baptism: YES NO First Communion: YES NO Confirmation: YES NO Cell:_____________________________ Texting? YES NO Church that the student attends:____________________________________________ Which

What is one way youre your youth is an inspiration to you and why? ______________________________________________ ______________________________________________________________________________________________________ Does your student have a Bible and/or Catechism at home? ______________________________________________________ One way that you would like us to pray for you is ____________________________________________________________

YOUTH MINISTRY Medical Consent, Permission/Release and Code of Conduct Form

Health: If your student has special needs (learning disability, handicaps, allergies, etc.), please indicate. ___________________________________________________________________________________________________ Who should be notified in case of emergency, if a parent cannot be reached? Name_______________________________________________________________________________ Phone__________________________________ Health Insurance Company__________________________________Policy No.___________________________________ Family Physician/Clinic________________________________________Phone ___________________________________

I, ____________________________, the parent or legal guardian of ___________________________authorize the employees, representative and chaperones of St Georges parish, including St. Stanislaus and St. Joseph Chapels, to obtain emergency medical treatment, should it be necessary, during my childs attendance and participation in FIAT Youth Ministry Programs from 09/12 to 08/13. I consent and give permission for my childs participation and attendance in this activity/program, this includes transportation for events corresponding to ministry events or those that I request. In consideration of my childs attendance and participation, I hereby, for myself, my heirs, executors, administrators and assigns, waive and release any and all claims for damages I may have against St. George Parish, the Roman Catholic Diocese of Boise, Idaho, their representatives, chaperones, employees arising out of any and all injuries by my child while participation in this activity/program. Date ______/_____/_____ Signature_____________________________

==================================================================== ====== CODE OF CONDUCT FOR ALL PROGRAMS TEEN CONTRACT I am a representative of St. Georges Parish Community and my actions at FIAT events will at all times reflect my Christian values. 1) Drugs, paraphernalia, or alcohol will not be in my possession/used by me at any FIAT function. 2) I will respect and cooperate with the adult leaders and follow any rules set up for the event. 3) I will respect and cooperate with my peers. I will work towards the good of the group. 4.) I will dress in a way that is modest and appropriate, including wording on t-shirts, bracelets, and clothes in general. 5.) My actions will avoid scandal, protect the purity of others, and seek to help those I am in contact with grow closer to God. With this signature, I agree that I have read, understand, and will follow the above. I understand that if my actions reflect otherwise, there will be consequences for my actions (ie. Discussion and/or call to parents to pick me up from event.) Teen Signature: _______________________________________________ Date: ___________ PARENT & PUBLIC RELATIONS INFORMATION I have read the above Teen Contract and can verify that my son/daughter has read and he/she understands what is expected. I understand that if my son/daughter does not act in accordance with the Teen Contract, his/her participation in the event, I will be expected to do what is necessary, this may mean I will pick up my son/daughter home immediately at my own expense. FACEBOOK: FIAT has created a Facebook group page with privacy settings for security purposes. You must be invited to be a friend to see information or pictures on the site. This is maintained by the Youth Coordinator as the administrator and is used to notify students of future events. Fr.Tim Ritchey is a co-administrator to monitor the interactions on the site. This is done periodically. Photos can be posted and tagged with names by youth members or administrators. No one who is not a friend can access any information without being granted permission from the administrator. Pictures: As the saying goes, a picture is worth a thousand words. Some pictures taken during FIAT activities and events may be sent to local/diocesan newspapers or used for marketing brochures to spread the good news about our youth group. Pictures in brochures will not identify individuals; however, newspapers request names to be attached to a picture sent in for a press release. If you do not wish for your son/daughters pictures to be published, please check all which apply. ____ I do not want my son/daughters photo sent to any newspaper. ____ I do not want my son/daughters photo placed in brochures. ____ I do not want my son/daughters photo on bulletin boards. ____ I do not want my son/daughters photo placed on the Facebook group page. Parent Signature:______________________________________________ Date: ___________ Areas I feel called to help FIAT Ministries in serving the youth of our parish are: ________Chaperone (Retreats/ Outings) ________ Driver to and/or from events (most within hour drive) ________ Core Team (Weekly volunteer) ________ Graduation Celebration Team (Collect Photos/Prepare Food/etc.) ________ Call me and I will help!!! ________ Confirmation Preparation Team (2x a month classes and/or Retreat) ________ Food Preparation (meals/donations) ________ Fundraising Team (Fall Festival, Sweet Shoppe, Dinner Auction, etc) ________ Giving Tree (Collect/Deliver Gifts) ________ Intercessory Prayer Team (Commit to praying for youth & families) ________ I have another idea as to where our family can donate our talents: _____________________________________________

__________________________________________________________________________________________________________ Please return completed registration form to: Jenn Jenson or Mail to: FIAT Youth Ministries C/O St. George Parish PO BOX 10 Post Falls, ID 83877 Questions? Contact Jenn Jenson: 773-4715 or 691-7569 (text messages are great, too) jennjenson777@gmail.com