Fun Night- Whirley Ball: 5055 Richmond Rd, Bedford Heights, OH 44146
Sunday, January 25th, 2025 7:00-9:00
Name
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First Name
Last Name
E-mail
*
example@example.com
E-mail good to contact for future events
example@example.com
Emergency Phone Number
*
I learned about Assumption Youth Ministries from:
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Facebook/Instagram
Attending Mass
Church Bulletin
Email
Other
Will you be carpooling with other children?
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Please fill out this waiver form for safety: Digital Waiver | Complete Your Waiver Today — WhirlyBall Cleveland
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Yes
No
Photo Release: I, the parent/guardian of my minor child do hereby consent and authorize the release, publication, dissemination, distribution, use, and/or reproduction of any and all photographs and/or filming taken of my daughter/son during his or her enrollment of parish youth group events at Church of the Assumption parish by an employee, agent, or representative. This Release and Authorization acknowledges that all videos and photos could be used and publicized on the Youth Group social media pages on Facebook and Instagram as well as the church website. Do you give consent to use your child's photo/image in these ways?
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I accept
I do not accept
Submit
Should be Empty: