St Leo's Faith Formation Registration, Permissions & Code of Conduct

St Leo's Faith Formation Registration, Permissions & Code of Conduct - - Kindergarten-5th grades

For school year 2022-2023
This is the form for ELEMENTARY Faith Formation for the year 2022-2023. We will do our best to offer both Wednesday and Sunday opportunities, take note on the time change for Sunday and be prepared that we may only be able to offer one option. Thank you for registering your child.
First Child*

First NameLast Name
First Child Name tag name
first name only
First Child Date of Birth*

MonthDayYear
Date
First Child's gender*

MaleFemale
First Child's grade*
First Child Which day is preferred*

Sunday 11:45am-1:10pmWednesday 5:30pm-6:45pm
First Child School*
which school does child attend
First Child Place of Baptism (if not baptized please indicate that)*
Church name, City & State
First Child Place of First Communion (if not received, please indicate that)
Church name, City & State
Second Child

First NameLast Name
Second Child Name tag name
first name only
Second Child Date of Birth

MonthDayYear
Date
Seond Child's gender

MaleFemale
Second Child's grade
Second Child Which day is preferred

Sunday 9:15am-10:15amWednesday 5:30pm-6:45pm
Second Child School
which school does child attend
Second Child Place of Baptism (if not baptized please indicate that)*
Church name, City & State
Second Child Place of First Communion (if not received, please indicate that)
Church name, City & State
Third Child

First NameLast Name
Third Child Name tag name
first name only
Third Child Date of Birth

MonthDayYear
Date
Third Child's gender

MaleFemale
Third Child's grade
Third Child Which day is preferred

Sunday 9:15am-10:15amWednesday 5:30pm-6:45pm
Third Child School
which school does child attend
Third Child Place of Baptism (if not baptized please indicate that)*
Church name, City & State
Third Child Place of First Communion (if not received, please indicate that)
Church name, City & State
Fourth Child

First NameLast Name
Fourth Child Name tag name
first name only
Fourth Child Date of Birth

MonthDayYear
Date
Fourth Child's gender

MaleFemale
Fourth Child's grade
Fourth Child Which day is preferred

Sunday 9:15am-10:15amWednesday 5:30pm-6:45pm
Fourth Child School
which school does child attend
Fourth Child Place of Baptism (if not baptized please indicate that)*
Church name, City & State
Fourth Child Place of First Communion (if not received, please indicate that)
Church name, City & State
Parent/Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Parent/Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Email address that is checked frequently
example@example.com
Family's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alternate Contact Person if parents are not available

First NameLast Name
Alternate Contact Person's Phone Number

Area CodePhone Number
We have access to:

Internet AccessA printer to print off lessons/activities
Use of Photos and or Video: I give St Leo's Parish Community permission to use photos or videos of my child taken during program activities for St Leo's promotional and informational purposes thoough social and or print media. (Your child's name and identitiy will not be used without getting additional permissions)
Initial if you agree to give permission for use of your child's/children's photo/video
Permission to share information with Grand Island Diocesan offices:
The Grand Island Diocesan Child Protection Office, the Faith Formation & Evangelization and the Youth & Young Adult Ministry Offices have requested the sharing of child's name. grade, parent's name & address. The use of thethis information is so that follow up on safe environment principles can be made with families and also to promote diocesan family and youth programs.
Do you wish to have your child's name, grade, parent's name & address shared with the Grand Island Diocesan offices?
Answer YES or NO
MEDICAL CONDITIONS: I hereby warrant that, to the best of my knowledge,my child is in good health and able to participate in program activities.Please list all known medical conditions including limitations and/orconditions of which we should be aware of:
(please list child's name if multiple children being registered)
ALLERGIES: Please list all known allergies, including how the child hasbeen treated and with what medication.
(please list child's name if multiplechildren being registered)
MEDICATIONS: please list all medications child is taking:
(please list child's name if multiplechildren being registered)
Type a question
Please indicate:

I prefer that she/he be responsible for these Medications her/himselfI prefer that the staff hod these medications and dispense accordingly
Every effort will be made to provide a safe environment physically,emotionally and spiritually for your child. Please note any additionalinformation you think the staff and volunteers should have to achieve thisgoal. This would include mental health issues and family dynamics such asdivorce or deaths in the family. This information will be keep confidential andwill only be used with staff and volunteers so that we can be sensitive to theneeds of your child.
(please list child's name if multiple children being registered)
Please indicate:

I DO give permission for this minor to be given over-the-countertreatments (such as Tylenol, Tums, Sudafed, etc) if she/he experiencesdiscomfort and requests treatment. Parents will be contacted prior todispensing any over-the-counter treatments.I DO NOT give permission for this minor to be given over-the-countertreatments (such as Tylenol, Tums, Sudafed, etc) if she/he experiencesdiscomfort and requests treatment. Parents will be contacted of anydiscomfort and requests for over-the-counter treatments.
AUTHORIZATION FOR MEDICAL TREATMENT: I/We, as the parents/legal guardian of the aforementioned minor residing at the above named address, understand that should a medical emergency of my child occur, St. Leo's Parish Community staff and volunteers will make every attempt to contact us.

I/We hereby grant St. Leo's Parish Community, their staff, and volunteers permission to transport this minor to an emergency medical or health care facility for immediate treatment and/or consultation, if deemed necessary. I/We understand that I/we will be notified of any emergency situation immediately and give permission for our child to be transported to a medical facility by ambulance if necessary.

I/We give authorization to the attending physician, dentist, or medical personnel for any required immediate treatment in the event that I/we cannot be reached at the time of the emergency. I/We agree to be financially responsible for any and all medical expenses and/or treatment costs and all related services provided to the above mentioned minor, and I/We release the St. Leo's Parish Community, their staff, and volunteers from any liability.
If you agree, place your initials here:
PERMISSION TO PARTICIPATE / TRANSPORTATION / RESPONSIBILITY FOR DAMAGE:

I/We understand that participation in the activities at St. Leo's Parish Community are sponsored by the St. Leo's Parish Community. I hereby grant permission for MY/OUR son/daughter to participate in the children / youth programs at St. Leo's Parish Community.

This includes being transported by staff and volunteers to and from some activity sites, with prior notification of such off-site activities by St. Leo's Parish Community staff.

I/We accept full responsibility for any legal or financial consequences which may result from any personal actions (ie. damage to property or other participants/staff/volunteers) taken by MY/OUR son/daughter, and I/WE agree to hold the St. Leo's Parish Community, their staff, and volunteers harmless with respect to any actions or claims that may be made in connection with personal actions taken by MY/OUR son/daughter.
If you agree, place your initials here:
INSURANCE/MEDICAL INFO: If medical attention to my child is deemed necessary during parish activities, I/We authorize the release of information of/to my/our insurance company and family physician: Insurance Company's name:
Insurance Company's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Insurance Company's Phone Number

Area CodePhone Number
Insurance Policy Number
Physician's Name
Physician's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physician's Phone Number

Area CodePhone Number
Signature of parent (E-Signature) to consent of your Child's/Children's participation in St. Leo's Parish Communities youth programs (valid for one year)

Clear
Date

MonthDayYear
Date
Code of Conduct
(parents, please review this code of conduct with your child)

To accomplish the purpose of children/youth ministry programs at St. Leo's Parish Community, everyone must agree to a “Code of Conduct.”
These guidelines are necessary to make participation enjoyable for all and to avoid problems. Participants have a responsibility to themselves and others to follow these guidelines:

Be Respectful and Safe. During childrens / youth ministry programs at St. Leo's Parish Community we expect to create an environment of safety and trust. The use of our bodies, language, and humor must always honor the dignity of every person. If you jeopardize the physical or emotional safety of yourself or the group, you choose to have a parent or guardian pick you up and take you home immediately.

Be Responsible and Honest. Participants are expected to be present at all activities on time and participate fully. Established guidelines will be observed at all times. We need to take care of the building and grounds. Any damage is to be reported immediately and involved persons are financially accountable. Emergencies that involve the health and well-being of people and/or property must be reported to staff and volunteers immediately.

The use of illegal drugs, including alcohol, or other illegal/harmful substances is not permitted. If you use these materials, you choose to have a parent or guardian pick you up and take you home immediately. Proper authorities will be notified. Do not bring clothing that advertises/promotes alcohol, tobacco or drug use or anything displaying messages that are offensive or contain sexual innuendo. These are contrary to the values of a Catholic children / youth ministry program.

Observe appropriate boundaries. All participants must stay in designated areas. Vehicles can only be used with specific permission from the director. For overnight retreats, males and females are lodged in areas with separate rooms. Participants do not enter each other’s rooms unless supervised by an adult. One of our goals is to relate with everyone present. If you engage in activities contrary to these guidelines or any activities that jeopardize your safety or the safety of the group, you choose to be removed from the activities. Your parent or guardian will be called to pick you up and take you home immediately.

Dress Code

In order to promote a safe, healthy and positive community experience the following dress code must be followed by all male and female participants and staff members. Shirts must be long enough to naturally touch the top of the lower garment, with arms raised.  Shirts must cover the shoulders. All attire should be sized to fit without exposing undergarments, buttocks, stomachs or cleavage.
 
Shorts and skirts must be fingertip length when arms are resting at sides
 
No Spaghetti straps, tank tops, and halter tops or transparent/mesh clothing or shirts with revealing necklines or armholes
 
No clothing or accessories that promote drugs, alcohol or tobacco either by brand or message
 
No clothing or accessories with sexually suggestive language or messages or clothing or accessories that promote violence, criminal activity, intimidation or intolerance of others (based on religion, ethnicity, gender or lifestyle)
 
Modest swim suit appropriate for a Catholic children's and youth's retreat setting.

Masks may be asked to be worn while on campus or inside the building. If it is asked, parents and students will oblige.
I/We understand and accept the guidelines and policies stated in this Code of Conduct. I will accept the consequences should my son/daughter choose to violate the code. I agree to come and pick up my son/daughter, should he/she choose to behave in a manner that the director and staff judge to be a serious violation of this code and is contrary to the mission of St. Leo's Parish Community.
Parental Signature, I have reviewed the Code of Conduct with my child (children):

Clear
Participant Signature, I - along with my parent(s)- have reviewed the code of conduct:

Clear
Participant Signature, I - along with my parent(s)- have reviewed the code of conduct:

Clear
Participant Signature, I - along with my parent(s)- have reviewed the code of conduct:

Clear
Participant Signature, I - along with my parent(s)- have reviewed the code of conduct:

Clear
Date

MonthDayYear
Date
Should be Empty:

St Leo's Faith Formation Registration, Permissions & Code of Conduct - - Kindergarten-5th grades

This is the form for ELEMENTARY Faith Formation for the year 2022-2023. We will do our best to offer both Wednesday and Sunday opportunities, take note on the time change for Sunday and be prepared that we may only be able to offer one option. Thank you for registering your child.