Form B

Diocese of Fort Worth and/or the Parish of*

Email id of Youth Minister from your Parish*

(This email ensures your Youth Minister is sent a copy of this form.)

CONSENT TO PARTICIPATE AND CONSENT FOR EMERGENCY MEDICAL TREATMENT

I, (Parent/Guardian's Name)*

grant permission for my child, (Youth Participant Name)*

to participate in the below described parish event. This activity will take place under the guidance and direction of parish employees and/or volunteers from the above named parish.

A brief description of the activity follows:

Description of event*

Date of event (MM/DD/YYYY)*

Destination of event*

Individual(s) in charge (1)*

Individual(s) in charge (2)

Estimated time of departure and return*

Mode of transportation to and from event*

Please accept

Transportation to/from event is the responsibility of the participant.

During this event, I give permission for either of the adults named above in charge of the event to consent to emergency medical or surgical treatment for (Youth Participant Name)*

Has there been any changes to personal information, insurance or medical information since you last filled out Form A for this child?*

YesNo

If Yes, The following changes to personal information, insurance and/or medical information since I last filled out Form A for my child named above are*

In case of emergency (Parent/Guardian's Name)*

Phone Number*

DIOCESE OF FORT WORTH CODE OF CONDUCT, EXPECTATIONS OF ALL PARTICIPANTS AND DRESS CODE

The purpose of this Code of Conduct is to identify personal behavior that is consistent with the purpose and objectives of the Diocese of Fort Worth. The items within the Code are based upon performance and are designed to protect the welfare of all participants.

CODE OF CONDUCT OF ALL YOUTH PARTICIPANTS:

Youth will respect themselves, other people, other people’s property, and church property.
Youth will participate and contribute in a positive way in all activities and obey the instructions of the youth ministry, adult volunteers, and staff.
During the event youth will show respect by not causing disruptions.
Harassment, intimidation or bullying will not be tolerated under any circumstances.
Youth will use language that reflects a Christian attitude. Youth will not use curse words or other foul language.
Youth will maintain a Christian witness to the dignity of each person: no tickling, wrestling, piggyback rides or inappropriate touching (which means: do not touch anyone anywhere that a bathing suit would cover). In addition, physical displays of affection such as kissing, full body hugs, sitting on laps, and lying or sleeping next to each other are inappropriate. Being isolated or alone with another student is not allowed.
Youth will wear modest clothing. No clothing that is sexually suggestive or spiritually degrading. T-shirts or other clothing with evil, vulgar, illegal, or inappropriate content will not be acceptable. In addition there should be: no midriffs, no low-cut tops, no spaghetti straps, no see through clothing, and no sagging pants to where underwear shows. Please do not wear short shorts. Shorts must follow the same guidelines as the school system.
Youth will stay with the group at all times during the event and will not leave early unless approval from a parent or guardian ahead of time or in person.
Youth will not possess any weapon of any kind (knife, gun, etc.) at any youth ministry activity at the church or event.
Youth will not use, possess or be under the influence of alcohol, tobacco, marijuana or any other illegal drugs at any youth ministry activity.
Youth will not engage in sexual intimacy or sexual harassment, and will not possess pornography at any youth ministry activity. Any illegal activity will prompt reporting to proper authorities depending upon the situation.

In the event the Code of Conduct is violated by a youth, proper diocesan protocols will be handled by the diocesan employee, pastor, youth minister or adult volunteer in charge. Failure to comply with the Code of Conduct will result in disciplinary action, up to and including removal from the event.

I have read and understand the above CODE OF CONDUCT, EXPECTATIONS OF ALL PARTICIPANTS and will comply.

Youth Participant Name*

Parent/Guardian/Conservator Signature*

Date (MM/DD/YYYY)

This is your electronic signature*

CONSENT TO PARTICIPATE AND CONSENT FOR EMERGENCY MEDICAL TREATMENT

DIOCESE OF FORT WORTH CODE OF CONDUCT, EXPECTATIONS OF ALL PARTICIPANTS AND DRESS CODE

CODE OF CONDUCT OF ALL YOUTH PARTICIPANTS: