• Jesus Night Registration

  • Are you registering a middle schooler, a high schooler, or as an adult youth ministry leader?

  • Middle School Participant Registration

  • Event Information

    Class/Grade Level :  7th and 8th Grade

    Event Description :  An evening of prayer and fellowship centered on an encounter with Jesus in the Eucharist

    Purpose of Event :  Faith Formation

    Date / Approx. Time of Check-In :  Sunday, October 18 at 6:00pm in the Hession Center, Door #3

    Date / Approx. Time of Departure :  Sunday, October 18 at 8:30pm in the Church

    Cost :  Free

    Other Notes : A meal will be provided.

  • Gender*
  • Faith Background*
  • Format: (000) 000-0000.
  • Please list any food allergies your child has and describe their severity below:
    Rows

  • I allow my child to participate in the parish event at the St. Charles campus on Sunday, October 18 from 6:00-8:30pm.


    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.

  • Below is a question about our Annual Emergency Medical Care Forms.

    Note: If your child participated in any of the following youth ministry activities this academic year, we should already have this information on file, and you can select "Yes".

    • Summer Series in June and July
    • Fall Kickoff on September 13

    If you are uncertain if you've completed this form during this academic year, please contact Anna Laisure at alaisure@scbfw.org.

  • Have you completed a St. Charles Annual Emergency Medical Care Form for your child in the 2026-2027 academic year or since July 1, 2026?*

  • 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!

  • High School Participant Registration

  • Event Information

    Class/Grade Level :  9-12th Grade

    Event Description :  An evening of prayer and fellowship centered on an encounter with Jesus in the Eucharist

    Purpose of Event :  Faith Formation

    Date / Approx. Time of Check-In :  Sunday, October 18 at 6:00pm in the Hession Center, Door #3

    Date / Approx. Time of Departure :  Sunday, October 18 at 8:30pm in the Church

    Cost :  Free

    Other Notes : A meal will be provided.

  • Gender*
  • Faith Background*
  • Format: (000) 000-0000.
  • Please list any food allergies your child has and describe their severity below:
    Rows

  • I allow my child to participate in the parish event at the St. Charles campus on Sunday, October 18 from 6:00-8:30pm.


    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.

  • Below is a question about our Annual Emergency Medical Care Forms.

    Note: If your child participated in any of the following youth ministry activities this academic year, we should already have this information on file, and you can select "Yes".

    • Summer Series in June and July
    • Fall Kickoff on September 13

    If you are uncertain if you've completed this form during this academic year, please contact Anna Laisure at alaisure@scbfw.org.

  • Have you completed a St. Charles Annual Emergency Medical Care Form for your child in the 2026-2027 academic year or since July 1, 2026?*

  • 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!

  • 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.

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