Registration Form
Please fill out one form for each child.
Full Name of Child
*
First Name
Last Name
Child's Age
*
Any allergies or medical conditions for child?
Parent Name:
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Participation Consent and Agreement
*
I, the undersigned parent or legal guardian of the above-named child, grant permission of the above-named child, grant permission for my child to participate in all activities offered by YMM - Catholic Youth Ministry's Monthly Kids Club, including but not limited to sports, arts and crafts, and outdoor games.
I understand that these activities involve inherent risks, including but not limited to physical injury, or property damage, and I acknowledge that YMM-Catholic Youth Ministry's Monthly Kids Club cannot eliminate all risks.
I confirm that my child is in good health and able to participate in the activities. In case of a medical emergency, I authorize YMM-Catholic Youth Ministry's Kids Club staff to seek and provide necessary medical treatment for my child, including but not limited to first aid, hospital visits, or administration of prescribed medications. I agree to cover any medical expenses occurred.
In consideration of my child's participation, I hereby release, waive, and discharge YMM - Catholic Youth Ministry, St. John the Baptist Parish, and the Diocese of St. Paul, its staff, volunteers and affiliates from any and all liability claims, or damages arising from my child's participation in the activities, except in cases of gross negligence or willful misconduct by YMM-Catholic Youth Ministry's Kids Club. I agree to indemnify and hold harmless YMM - Catholic Youth Ministry, Monthly Kids Club, St. John the Baptist Parish, and the Diocese of St. Paul from any claims brought by or on behalf of my child.
I grant YMM - Catholic Youth Ministry's Kids Club permission to use photographs or videos of my child taken during Monthly Kids Club activities for promotional purposes, including posting on the website, social media, or printed materials, unless otherwise indicated below.
I understand that my child is expected to follow YMM-Catholic Youth Ministry's Kids Club rules and behave appropriately. YMM-Catholic Youth Ministry's Kids Club reserves the right to dismiss my child from the program without refund for serious or repeated behaviour issues.
Photo/Video Consent
Please choose ONE only:
*
Photo/Video Release: I opt out and DO NOT grant permission.
Photo/Video Release: I DO give permission.
Parent/Guardian Signature:
*
Date Signed:
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Thank you for registering and we look forward to seeing you on Wednesday, September 16th, 2026 at our Monthly Catholic Kids Club!
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