Youth Ministry Registration 2026-2027

Youth Ministry Registration 2026-2027

Youth Ministry meets on Sunday's from 6:00 PM-7:30 PM, September through April the Newman Center at Kent State (1424 Horning Rd, Kent, OH 44240).
Youth Name

First NameLast Name
Youth Age
Youth Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Youth Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Youth Email Address
example@example.com
Family Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Youth Attends
Parish Youth Attends
Grade Level
Does the teen have any allergies (if yes, please detail)?
Does the teen have any medical conditions that we should be aware of (if yes, please detail)?
Parent/Guardian Information
Parent (1) Name

First NameLast Name
Parent (1) Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent (1) Email
example@example.com
Parent (2) Name

First NameLast Name
Parent (2) Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent (2) Email
example@example.com
Additional Emergency Contact

First NameLast Name
Emergency Contact Relationship to Youth
Emergency Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
To inform emergency medical personnel, please provide name of your family doctor and physician phone number:
Permissions
I give permission for my son/daughter to be photographed or videoed at youth events with Saint Katharine Drexel Parish within the Diocese of Youngstown. I realize that the photo or video may be published in the newspaper, magazine, parish website, or other publication deemed appropriate by the Parish or for informational or educational purposes.
I give permission to Saint Katharine Drexel Parish to contact my son/daughter directly on the cell phone and email provided above.
Authorization and Waiver
In the event reasonable attempts to contact me have been unsuccessful:
Acknowledgment
By registering my child to participate in the Youth Ministry Program of Saint Katharine Drexel Parish, I hereby assume all risk of accident or harm arising or growing out of, directly or indirectly, any incident of any kind occurring during the course of such program to my child and do hereby release, absolve, hold harmless, indemnify and discharge the Roman Catholic Diocese of Youngstown, the Bishop of the Diocese of Youngstown, Saint Katharine Drexel Parish, and the agents, sponsors, volunteers, associates, and employees of the Bishop and Saint Katharine Drexel Parish, who have organized or participated in the supervision of such program from all claims, demands, suits, judgments, causes or actions, rights, costs, expenses, liability and any compensations whatsoever which may occur to my family and its members during or resulting from participating in the program mentioned. I further understand that any photographs or video taken at Youth Ministry sessions/events may be used at the discretion of the Pastoral Associate without consideration of any kind.
Parent/Guardian Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Youth Ministry Registration 2026-2027

Parent/Guardian Information

Permissions

Authorization and Waiver

Acknowledgment