ChristLife Registration Form
Discovering Christ. October 28 - December 16
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
How did you hear about ChristLife?
*
Please Select
Parish Newsletter
Facebook/ IG
Parish Bulletin
Other
Please Specify
Food restrictions/allergies
*
Emergency Contact (you will be listed as emergency contact for your family/attendees unless otherwise stated)
*
Name and phone #
If willing, share a bit about your faith journey.
Are you currently a registered member of St. Paul?
Yes
No
Family Information
List the names of family attending with you (child care is available with advance registration).
Please list name, relation and age of participants:
Childcare registration available on submission
Consent to photograph
*
Please Select
I consent
I do not consent
I hereby authorize the Diocese of Pensacola-Tallahassee, including its parishes, schools, and institutions(hereinafter referred to as “Diocese of Pensacola-Tallahassee”) to use, prepare, reproduce, record, video tape,publish, distribute, broadcast, electronically store, and exhibit my name, image, portrait, likeness, words, and/or voice in connection with interviews, sessions, or events conducted, sponsored, or arranged by the Diocese of Pensacola-Tallahassee and its employees, volunteers, and agents. I acknowledge that any notes, photographs,motion pictures, digital images, recordings, or other media format taken of me will become the property of the Diocese of Pensacola-Tallahassee, and I specifically waive any right to compensation for the foregoing. I understand that my likeness, name, image, or voice may be used by the Diocese of Pensacola-Tallahassee without limitation for any professional purpose, now or in the future, and I consent to the same. This permission extends to any authorized print or broadcast media organization that may participate in such preparation, use,reproduction, publication, or distribution.I release the Diocese of Pensacola-Tallahassee and its employees, volunteers, agents, and designees from liability for any violation of any personal or proprietary right I may have in connection with such use. I also hereby waive any right I may have to inspect and approve in advance the photographs, videos, sound recordings, or publications or media in which I am included. I agree to release the Diocese of Pensacola-Tallahassee and its employees,volunteers, agents and designees from any liability by virtue of the use of the photographs or video recordings,regardless of any blurring, distortion, optical illusion, or alteration which may occur when the photographs or videos are taken, printed, or displayed.A photocopy of this release shall be as valid and enforceable as the original.
Submit
Should be Empty: