St. Mary Youth Group
2024-2025 Registration
Student Information
Student Name
*
First Name
Last Name
Student Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Email if applicable
Parish
*
Type n/a if not connected to a parish
Age
*
Male/Female
*
Male
Female
School Attending
*
Current Grade (2024-2025 School Year)
*
Allergies, medical needs, or any other concerns we should be aware of?
*
T-shirt size (adult unisex sizing)
*
S
M
L
XL
Optional Student Information
If your answers have not changed from last year, feel free to leave blank.
Favorite youth group game or activity
Favorite youth group snack
Confirmation Saint (if applicable)
What do you desire from youth group this year?(knowledge, growth in prayer, friendships, etc.)
What is one way we can pray for you?
Any other comments, questions, or concerns regarding youth group?
Parent/Guardian Information
Parent/Guardian Name
*
First Name
Last Name
Relationship to Student
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Parental Consent
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor (“participant”). I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns to hold harmless and defend St. Mary Catholic Parish, its officers, directors, employees and agents, and the Diocese of Spokane, its employees and agents, chaperones, or representatives associated with the event, from any claim arising from or in connection with my child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate St. Mary Catholic Parish, its officers, directors and agents, and the Diocese of Spokane, its agents and chaperones, or representative associated with the event for reasonable attorney’s fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of St. Mary Catholic Parish or the Diocese of Spokane.
Parental Consent: Parent/Guardian Signature
*
Date of Signature
*
-
Month
-
Day
Year
Date
Media Release
Photographs and Videos: Parents/guardians of participants are advised that photographs or videotape of participants may be used in publications, websites or other materials produced periodically by the St. Mary Catholic Parish or the Diocese of Spokane. (Participants would not be identified without specific written consent. Parents/guardians who do not wish their child(ren) to be photographed or filmed should so notify St. Mary Catholic Parish/Diocese of Spokane in writing. Please note that St. Mary Catholic Parish/Diocese of Spokane has no control over the use of photographs or film taken by media that may be covering the event in which your child(ren) participate.
Parental Consent: I consent to the Media Release as listed above
*
Yes
No
Parental Consent: Parent/Guardian Signature
*
Emergency Contact
Please list one emergency contact for the student different from the parent information above
*
First Name
Last Name
Relationship to student
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Important!
After you click submit, you will receive an email to the address you listed in the parent section. This email contains links for how we will communicate this year (Flocknote, Signal, and St. Mary website). Please read through it and make sure you are signed up for the appropriate platforms. It is the only way I can get the word out on awesome opportunities!
Submit
Submit
Should be Empty: