SAP Registration 2014

SAP Registration 2014

35.00

Summer Activities Program

The Summer Activities Program is starting its 6th Year at St. Francis of Assisi! We are a program for students entering 6th through 13th grade for school year 13’- 14’. The purpose of the Summer Activities Program is to strengthen the Church by promoting fellowship, discipleship, and leadership among the youth as well as to provide a fun, safe environment for teens in-between school terms!

 

Submit the form below before registering!

The form below is for office purposes and the form for payment is for accounting purposes. Thank you!

Quantity:
Register

Registration Form

Youth’s Name: *
Youth’s Name:
Youth's Date of Birth *
Youth's Date of Birth
Youth's Phone *
Youth's Phone
Parent's Contact Info
Mother's Phone *
Mother's Phone
Father's Name
Father's Name
Father's Phone *
Father's Phone
Emergency Contact Info
Person (other than parent) to contact in case of an emergency *
Person (other than parent) to contact in case of an emergency
Best Phone Number
Best Phone Number
Medical Form
Physician's Phone *
Physician's Phone
Checkbox *
I, the parent/guardian of the above named youth, hereby give my permission for his/her participation in the event(s) mentioned and direct my son/daughter to cooperate and confirm with directions and instructions the parish, school, and diocesan personnel responsible for the youth activity. I agree that in the event my son/daughter is injured as a result of his/her participation in the above named activities, including transportation to and from these activities, whether or not caused by the negligence (active or passive) of the school or diocesan youth activities program, or any of its agents or employees, resource for the payment of any resulting hospital, medical, or related costs and expenses will first be had against any accident, hospital, or medical insurance or any available benefit of mine. In the event we cannot be reached in an emergency, I/We hereby give permission for the Youth /Event Leaders/Chaperones to authorize by his/her signature whatever medical treatment may be necessary by the attending physician for my/our child. I am not aware of any medical condition of my child which would render it inappropriate for him/her to participate in any such activity.