LIFETEEN 2024-2025 Registration Form

St. Barnabas' Life Teen 2023-2024 Online Registration Form
The St. Barnabas Youth Ministry is excited to have your child and your family join us this new school year!

Please note that the online registration form is PART 1 of registering your child(ren). PART 2 is the registration fee.

To help with running LIFETEEN throughout the year, we ask for a donation of $50 each child (for each additional child, we ask for an additional donation of $40). Once you complete the online registration form, please submit fee to the St. Barnabas office with your child(ren)'s Full Name(s), and with the title "LIFETEEN 2024-2025". We accept either cash or cheque. For cheque, please write on the note "LIFETEEN 2024-2025" and payable to "St. Barnabas Catholic Church". Alternatively, you can pay using credit card below.

Lastly, one registration form submission is for one child only; if you have more than one child registering for LIFETEEN, you would have to submit two or more registration forms.

Parent/Guardian Information
Parent/Guardian 1 Name*

First NameLast Name
Parent/Guardian 2 Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*
Please enter a valid phone number.
Cellphone Number
Please enter a valid phone number.
Parent/Guardian Email Address:

We will be communicating by email whenever possible to keep you up to date on upcoming dates and events. All emails sent will be strictly related to our Life Teen Program.
Email*
example@example.com
Emergency Contact Person*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Relationship with the Child*
I would like to be contacted to assist with LIFE TEEN dinners throughout the year:*

YesNo
I would like to be contacted to assist with LIFE TEEN environment throughout the supplies:*

YesNo

Payment

My Products

St. Barnabas Lifeteen 2024 - 2025

$50.00CAD

Additional Child

$40.00CAD Quantity

Total

$0.00CAD

Credit Card

Consent/Waiver
The LIFE TEEN Program is a cell phone free zone; LIFE TEENers will not be permitted to use their phones or any electronic devices during the program.*

YesNo
I hereby grant permission for my child to be photographed and/or recorded at any time. I further grant permission for the resulting photographs and/or video footage to be edited, if necessary, and then published and/or used for the purpose of promoting LIFETEEN and/or youth programs at St. Barnabas Parish.*

YesNo
I/We understand that reasonable precaution will be taken to safeguard the health and safety of the participant. I/we will be notified as soon as possible in case of emergency. If, however, I/we are not available, the designated emergency contact person will be notified as soon as possible in case of emergency. In the event of any sickness or accident, person(s) will not hold St. Barnabas, the Archdiocese of Toronto, any volunteer, chaperone, or driver responsible. I/We authorize and consent that emergency treatment be rendered under the general or specific supervision and on the advice of any physician, dentist, or surgeon; licensed to practice in the Province of Ontario or any other Province in Canada. The undersigned understand(s) and agrees that any medical, dental, or hospital expense incurred shall be at their own risk. The undersigned understand(s) every effort will be made to notify the parents or emergency contact in the event that treatment is necessary.
Signature*

Clear
Date

MonthDayYear
Date
Should be Empty:

St. Barnabas' Life Teen 2023-2024 Online Registration Form

Participant's Information

Parent/Guardian Information

Parent/Guardian Email Address:

Payment

Credit Card

Consent/Waiver