Holy Redeemer Catholic Church

Holy Redeemer Catholic Church

K-12 (CCD) Youth Evangelization Registration Form
Family Information
Fathers Name*

First NameLast Name
Mothers Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Fathers Phone Number*
Mothers Phone Number*
Fathers E-mail
example@example.com
Mothers E-mail
example@example.com
If parents are separated/divorced-which parent should be contacted?
Parish communications and announcements will now be sent using flocknote. We will be adding you to your child's classroom and any applicable ministry groups you register for. You will be receiving a text to set up your account if you have not done so already in the coming months.*

Okay, I will look for your text and then set up.I have already set up my Parish Flocknote Account, please use that.

Family Emergency Information
Medical Insurance Co.
Policy#
Policy Holder's Name:
Policy Holder's Birthdate:

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Home Phone Number
Cell Number
Family Doctor
Doctor Office Phone
Please enter a valid phone number.
Family Dentist
Family Dentist Phone
Please enter a valid phone number.
In Case of Emergency Contact 1 Name
Relationship to Student(s)
Contact 1 Number
Please enter a valid phone number.
In Case of Emergency Contact 2 Name
Relationship to Student(s)
Contact 2 Number
Please enter a valid phone number.

Youth Ministry

Opportunities for all ages listed below!
Please list your child/children below each of the following Youth Ministry opportunities they may be interested in learning more about and we will reach out to you with more information soon. -OR- if there is a new ministry you would be interested in getting started, please list that below...
Elementary Students (1st-6th)
Children's Choir (2nd-6th)
Children's Choir will be held in-between Session A and B at Holy Redeemer this year from 5:00-5:30p on Wednesdays. Please list any who may be interested in joining and we will be in contact with you with more information.
Child/Children's Name(s) name Grade(s) grade
Little Saints Club (1st-6th)
Little Saints Club will meet the second Thursday of the month from 6:00-7:00pm at Holy Redeemer.
Dates: Oct 10, Nov 14, Dec 12, Jan 9, Feb 13, Mar 13, April 10

Monthly meetings will include a round robin setup, each student will get 15-20 minutes at a lesson, craft, and game to go along with the Saint of the Month… Learn how to be a Little Saint from some of the Big Ones!

Yes! Please register my Child/Children for Little Saints ($20 each)

Child/Children's Name(s) name Grade(s) grade Please Provide an email for registration to be sent:Email
Junior High Students (7th-8th)
First Friday Club (7th-8th)
Meets on the 1st Fridays to pray and have breakfast together.
Child/Children's Name(s) name Grade(s) grade
Youth Bible Study (7th-8th)
Bible Study is for students wanting to dig a little deeper into God's word.
Child/Children's Name(s) name Grade(s) grade
High School Students (9th-12th)
First Friday Club (9th-12th)
Meets on the 1st Fridays to pray and have breakfast together.
Child/Children's Name(s) name Grade(s) grade
Dates with Jesus (9th-12th)
Once a Month: Girls from Grades 9-12th learn through Jesus how you deserve to be loved.
Child/Children's Name(s) name Grade(s) grade
Man of Courage (9th-12th)
Once a Month: Boys from Grades 9-12th learn traits of courageous men.
Child/Children's Name(s) name Grade(s) grade
Youth Fellowship Meal (6th-8th)
This meal is held from 6-6:45p before each held Wednesday CCD Class. It is a great opportunity for our youth to gather in fellowship with one another before attending their CCD Session C from 6:45-7:45p. Each week includes a full meal for 60-100 students.

There are many ways you can help by donating items such as food, drinks and desserts. You may also help by donating time with cooking, preparing meals or tables, cleaning up, dishes, and most importantly fellowship with our youth. If you or someone you know would be willing to help for one week or more, please provide your contact information below and you will be added to our Youth Fellowship Meal group in flock note and/or someone will reach out to you with more information.

Name: First Name Last Name Phone: 000-000-0000

I'm Interested In helping with...
Questions or Comments:

2024/2025 Emergency Medical Release Form

This release form will apply to allactivities of the Holy Redeemer Religious Education and Youth Ministry programs. Youths are given permission toparticipate in events from September 1, 2024 through August 31, 2025. It is theresponsibility of the parent/guardian tonotify Holy Redeemer Catholic Church if any information changes during thisperiod.
ARCHDIOCESE OF CINCINNATI PERMISSION, RELEASE AND MEDICAL POWER OF ATTORNEY (Rev. 7-2005)

Please Initial all agreed upon boxes, especially #6 on social media/website (or leave#6 blank to decline permission).
initial* I, the parent or lawful guardian of all children listed on the CCD registration form, give permission for my child to participate in the activity described on the Activity Information form (the “Activity”) and release from all liability and indemnify the Archdiocese of Cincinnati (the “Archdiocese”), the Archbishop of Cincinnati (the “Archbishop”), both individually and as trustee for the Archdiocese of Cincinnati, and all parishes and schools within the Archdiocese, and their respective officers, agents, representatives, volunteers, and employees from any and all liability, claims, judgments, cost and expenses, including attorneys’ fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from the Activity and further agree not to bring or prosecute or allow to be brought or prosecuted (including but not limited to prosecution through subrogation) in my name, or on behalf of my Child, any claims, lawsuits or actions against the Archbishop, the Archdiocese, and their respective officers, agents, representatives, volunteers and employees.
initial* I further understand that my Child’s participation in the Activity is purely voluntary and is a privilege and not a right, and that my Child, and I on behalf of my Child, agree to my Child’s participation in the Activity in spite of the risks.
initial* I agree to instruct my child to cooperate with the Archbishop or his agents in charge of the activity.
initial* I appoint the Archbishop or his agents who are acting as leaders of the Activity as my attorney in fact to act for me in my name and my behalf, in any way that I would act if I were personally present, with respect to the following matters if any injury, illness or medical emergency occurs during the activity or related travel:

(i) To give any and all consents and authorizations to any physicians, dentist, hospital or other persons or institutions pertaining to any emergency medications, medical or dental treatments, diagnostic or surgical procedures or any other emergency actions as our attorney shall deem necessary or appropriate for the best interest of the Child.

(ii) I understand that the agents of the Archbishop will make a reasonable attempt to contact me as soon as possible in the event of a medical emergency involving my child.
initial* This power of attorney shall lapse automatically upon completion of the activity and related travel.
initial I agree that the Archbishop, his agents, or Holy Redeemer may use a photograph, video or other likeness of my child for promotional purposes, website and office functions and use social media and technology to communicate to my child regarding ministry related activities. If unsigned, I agree to instruct my child to not participate in any pictures or social media events such as streaming.
initial* This acknowledgement and release is intended to be as broad and inclusive as permitted by the law of the State of Ohio, and if any portion hereof is declared invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This acknowledgement and release shall be construed in accordance with the laws of the State of Ohio, except for the choice of law provisions thereof.
I have carefully read and understand and accept the terms and conditions statedherein and acknowledge that this Permission, Release and Medical Power ofAttorney shall be effective and binding upon me, my Child, and my own and myChild’s personal representative or estate, assigns, heirs, and next of kin andthat I have signed this agreement of my own free will.
Please Type Name Above
Date

MonthDayYear
Date
Signature

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Registration Fees

Grades K-12 are $50 per child *Max of $150 per family
How Many Children Did you register for CCD*

One Child - $50Two Children - $100Three or More Children - $150
Are any of your Elementary Children (2nd-6th grade) participating in the Little Saints Club

One Child - $20Two Children - $40Three or More Children - $60Not at this time

Payment Options

Due By: June 1st, 2024
Please select how you intend to pay this year's fees.*

1. MAIL A CHECK TO: Write check out to Holy Redeemer Church Holy Redeemer Catholic Church - PO BOX 67 - New Bremen, OH 45869 c/o CCD R𝗘𝗚𝗜𝗦𝗧𝗥𝗔𝗧𝗜𝗢𝗡2. COLLECTION BASKET: Write check out to Holy Redeemer Church and put payment in an envelope labeled CCD 𝗥𝗘𝗚𝗜𝗦𝗧𝗥𝗔𝗧𝗜𝗢𝗡.3. DROP IT OFF AT THE PARISH Office - Between the hours of 9:00- 4:30 - Monday - Thursday4. OR PLACE IN OFFICE MAILBOX Write check out to Holy Redeemer Church and put payment in an envelope labeled CCD 𝗥𝗘𝗚𝗜𝗦𝗧𝗥𝗔𝗧𝗜𝗢𝗡. Box outside office doors - Non-Business Hours5. PAY ONLINE: A Credit Card Service Fee of 3% of the total amount due with an additional $0.35 transaction fee will be added to your total bill, to cover the credit card charge. Use Vanco Faith Below.Family unable to financially meet the yearly fees, we ask that you please contact the parish office. Assistance is available to help cover partial or all fees.
Should be Empty:

Holy Redeemer Catholic Church

Student #1 Information

Student #2 Information

Student #3 Information

Student #4 Information

Student #5 Information

Family Emergency Information

Youth Ministry

Elementary Students (1st-6th)

Junior High Students (7th-8th)

High School Students (9th-12th)

Youth Fellowship Meal (6th-8th)

Volunteer Opportunities

2024/2025 Emergency Medical Release Form

ARCHDIOCESE OF CINCINNATI PERMISSION, RELEASE AND MEDICAL POWER OF ATTORNEY (Rev. 7-2005)

Registration Fees

Payment Options