Youth Group Registration Form
High School Cotillion Semi-Formal & Awards Dinner 03/23/2018
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Description of What Will Take Place:

Name of Event: High School Cotillion Semi-Formal & Awards Dinner
Destination: Archdiocesan Youth Retreat Center (499 Belgrove Drive, Kearny)
Designated Supervisor of Activity: Lee Ann Rivera
Meeting Date and Time: Friday, March 23, 2018 (7:00pm)
Pick-Up Time: Friday, March 23, 2018 (11:00pm)
Method of Transportation: Meet at Archdiocesan Youth Retreat Center
Cost: $35

**  Youth Group should be dressed in semi-formal attire.
**  A Code of Conduct form must be completed for all youths. Download Code of Conduct: Please print and drop off at the Parish Office as soon as possible.
**  Permission slips and credit card payments will be available on the parish website until the deadline date. 

Description of What Will Take Place:

Name of Event: High School Cotillion Semi-Formal & Awards Dinner
Destination: Archdiocesan Youth Retreat Center (499 Belgrove Drive, Kearny)
Designated Supervisor of Activity: Lee Ann Rivera
Meeting Date and Time: Friday, March 23, 2018 (7:00pm)
Pick-Up Time: Friday, March 23, 2018 (11:00pm)
Method of Transportation: Meet at Archdiocesan Youth Retreat Center
Cost: $35

**  Youth Group should be dressed in semi-formal attire.
**  A Code of Conduct form must be completed for all youths. Download Code of Conduct: Please print and drop off at the Parish Office as soon as possible.
**  Permission slips and credit card payments will be available on the parish website until the deadline date. 

Highlighting our youth involvement in our youth ministry and recognizing their accomplishments increases motivation and promotes self-esteem.  We are requesting your permission to release your child's photo and/or video for Church use including our website, social media, and to the local news media.  

If you would like your child to participate in this event, please agree to the following statement of consent and release of liability.  As parent or legal guardian, you remain full responsibility for any legal responsibility which may result from any personal actions taken by the named student.

I request that my child(ren), participate in the event described above. I understand that this event will take place away from the Church grounds and that my child will be under the supervision of the designated Church employee or volunteer on the stated dates. I further consent to the conditions stated above on participation on this event, including the method of transportation and use of photo and video. I understand and agree that in the event that my child should suffer injury of any sort while participating in the event described above, unless such injury is solely caused by their intentional conduct, I agree to hold harmless, and not to pursue any claims against the Church/Church group sponsoring this activity, or any of its agents, servants, or employees, as a result of such injury.