St. Rose of Lima Parish Youth Ministry

St. Rose of Lima Parish Youth Ministry

Edge is a Catholic middle school youth ministry experience created to provide a fun and safe place for youth to find Catholic community, discover answers to their questions about faith and encounter Jesus in a personal way. Open to youth in grades 6 to 8. Our Edge nights are once a month on every last Thursday of each month from September to May from 6pm to 8:30pm. The cost per child per year is $20.00, this covers the cost to run the program. Please fill out one form per child.
Youth's Name*

First NameLast Name
School Name*
Parish Name
Grade *
Youth's birthdate

MonthDayYear
Date
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Father's Name

First NameLast Name
Father's cell number
Format: (000) 000-0000.
Father's e-mail
example@example.com
Mother's Name

First NameLast Name
Mother's cell number
Format: (000) 000-0000.
Mother's e-mail
example@example.com
Whom may we contact in case of emergency?*

First NameLast Name
Emergency Contact Phone #:*
Please enter a valid phone number.Format: (000) 000-0000.
Child's Health Card Number (in case of emergency)
Child Allergies/Medical Conditions: (type none if no allergies or medical conditions)*
Child Learning Accomodations:
PARENT/GUARDIAN CONSENT

RELEASE

I understand that reasonable precaution will be taken to safeguard the health and safety of the participant and the designated emergency contact person will be notified as soon as possible in case of emergency. In the event of any sickness or accident persons will not hold St. Rose of Lima Parish, The Archdiocese of Toronto, any volunteer, chaperone or driver responsible.

PERMISSION
In signing this, I am granting my child permission to participate in the EDGE program at St. Rose of Lima Parish.

PICK-UP
I understand that I/whomever is responsible will be expected to pick up my child at the end of each EDGE night.

INFORMATION
I consent to having St. Rose of Lima Parish collect personal information that may include identification information, parent/guardian contact information, emergency contact information, and any similar information required for registration. (All information is kept strictly confidential)
I DO grant permission for my youth to be photographed and/or video recorded during EDGE activities. I further grant permission for resulting photographs and/or videos to be published if necessary, for the purpose of promoting youth programs at St. Rose of Lima Parish on printed materials, social media and on our website.I DO NOT grant permission for my youth to be photographed and/or video recorded during EDGE activities. I have instructed my child to decline to be photographed and/or video recorded at all times and to notify EDGE Leaders that they may not do so
Signature

Clear
By typing your name here, you are giving consent to above statements. Your actual signature will be taken when you bring your child to their first Edge night.*

First NameLast Name
REGISTRATION FEE: $20 per child. Payable by cash or cheque (made payable to St. Rose of Lima Parish.) Fee includes simple food and activity materials.

If you have any questions, please contact Christine at strose.ym2024@gmail.com. Thank you!
Name

First NameLast Name
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