2025 Fall Kickoff Registration

2025 Fall Kickoff Registration
Are you registering a middle schooler, a high schooler, or as an adult youth ministry leader?

Middle School ParticipantHigh School ParticipantAdult Chaperone

Middle School Participant Registration
Event Information

Class/Grade Level : 7th and 8th Grade

Event Description : A time to gather together, play games, and celebrate the canonization of our 2 newest saints: Sts. Carlo Acutis and Pier Giorgio Frassati!

Purpose of Event : Community Building

Date / Approx. Time of Check-In : Sunday, September 7 at 3:00pm at the St. Charles Youth Center, 4904 Trier Rd, Fort Wayne, IN 46815

Date / Approx. Time of Departure : Sunday, September 7 at 5:00pm at the St. Charles Youth Center, 4904 Trier Rd, Fort Wayne, IN 46815

Cost : Free

Other Notes : Pizza will be provided.
Youth Participant Name*

First NameLast Name
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
I allow my child to participate in the parish event at the St. Charles Youth Center on Sunday, September 7 from 3:00-5:00pm.

In consideration of the aforementioned participant, my child, being allowed to participate in this event, I, on behalf of myself, my child and my child’s other parent/guardian, hereby acknowledge recognition that such an activity may expose my child to risks and hazard not ordinarily encountered in the parish youth ministry program. Further, on behalf of myself, my child, and my child’s other parent/guardian, I hereby release and agree to hold harmless the above named parish and the Diocese of Fort Wayne-South Bend, Inc. to the fullest extent permitted by law from any and all claims, judgments and liability of every kind for any injury and damage of any kind, whether personal or property, that we or any one of us may suffer or incur due to my child’s participation in the event, regardless of whether the injury or damage is attributable to the fault of parties other than the Parish or Diocese or attributable to the fault, including negligence, of the Parish or Diocese.

I have instructed my child to follow the rules of conduct as directed by the parish youth ministry program and Diocese.

Middle School Annual Emergency Medical Care Form
Due to the nature of this event, all participants MUST sign an emergency medical care form. For your convenience, we have embedded it here. However, this is technically a separate form which is why you have to type your name and email again. It has a GREEN "Submit" button.

After clicking the GREEN "Submit" button, please be sure to scroll to the bottom of this page and click the BLUE "Next" button.

THERE IS ANOTHER PAGE AFTER THIS! Your registration is not complete yet, so do not close out of this tab!
Please check before moving on.*

I am verifying that I have signed and submitted the above Annual Emergency Medical Care Form for my child.

High School Participant Registration
Event Information

Class/Grade Level : 9-12th Grade

Event Description : A time to gather together, play games, and celebrate the canonization of our 2 newest saints: Sts. Carlo Acutis and Pier Giorgio Frassati!

Purpose of Event : Community Building

Date / Approx. Time of Check-In : Sunday, September 7 at 6:00pm at the St. Charles Youth Center, 4904 Trier Rd, Fort Wayne, IN 46815

Date / Approx. Time of Departure : Sunday, September 7 at 8:00pm at the St. Charles Youth Center, 4904 Trier Rd, Fort Wayne, IN 46815

Cost : Free

Other Notes : Pizza will be provided.
Youth Participant Name*

First NameLast Name
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
I allow my child to participate in the parish event at the St. Charles Youth Center on Sunday, September 7 from 6:00-8:00pm.

In consideration of the aforementioned participant, my child, being allowed to participate in this event, I, on behalf of myself, my child and my child’s other parent/guardian, hereby acknowledge recognition that such an activity may expose my child to risks and hazard not ordinarily encountered in the parish youth ministry program. Further, on behalf of myself, my child, and my child’s other parent/guardian, I hereby release and agree to hold harmless the above named parish and the Diocese of Fort Wayne-South Bend, Inc. to the fullest extent permitted by law from any and all claims, judgments and liability of every kind for any injury and damage of any kind, whether personal or property, that we or any one of us may suffer or incur due to my child’s participation in the event, regardless of whether the injury or damage is attributable to the fault of parties other than the Parish or Diocese or attributable to the fault, including negligence, of the Parish or Diocese.

I have instructed my child to follow the rules of conduct as directed by the parish youth ministry program and Diocese.

High School Annual Emergency Medical Care Form
Due to the nature of this event, all participants MUST sign an emergency medical care form. For your convenience, we have embedded it here. However, this is technically a separate form which is why you have to type your name and email again. It has a GREEN "Submit" button.

After clicking the GREEN "Submit" button, please be sure to scroll to the bottom of this page and click the BLUE "Next" button.

THERE IS ANOTHER PAGE AFTER THIS! Your registration is not complete yet, so do not close out of this tab!

If you signed this during our 2025 summer series or your child participated in our walking pilgrimage on July 30, you do NOT have to complete this form.
Please check before moving on.*

I am verifying that I have signed and submitted the Annual Emergency Medical Care Form for my child for this academic year.

Adult Chaperone Registration
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Are you volunteering for the middle school event, high school event, or both?*

Middle SchoolHigh SchoolBoth
Due to the nature of this event, we are requiring our chaperones to sign an emergency medical care form. For your convenience, we have embedded it here. However, this is technically a separate form which is why you have to type your name and email again. It has a GREEN "Submit" button.

After clicking the GREEN "Submit" button, please be sure to scroll to the bottom of this page and click the BLUE "Next" button.

THERE IS ANOTHER PAGE AFTER THIS! Your registration is not complete yet, so do not close out of this tab!

If you participated in our walking pilgrimage on July 30 or our pilgrimage to Detroit on August 2, you do NOT have to complete this form.
Please check before moving on.*

I am verifying that I have signed and submitted the Annual Emergency Medical Care Form for this academic year.

Thank you for registering for this event! Please provide a signature below to finalize your registration. If you have questions abour your registration or about the event, please contact Anna Laisure at alaisure@scbfw.org.
Signature*

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2025 Fall Kickoff Registration

Middle School Participant Registration

Middle School Annual Emergency Medical Care Form

High School Participant Registration

High School Annual Emergency Medical Care Form

Adult Chaperone Registration