Youth Group Registration Form
High School Service Day Retreat #2
(Foodbank & NYC) 11/04/2017
0% Family Address

Description of What Will Take Place:

Name of Event:
High School Service Day Retreat #2 (Foodbank & NYC) Locations: (See below)
Designated Supervisor of Activity: Lee Ann Rivera
Meeting Date and Time: Saturday, Nov. 4, 2017 (9:00am)
Pick-up Date and Time: Saturday, Nov. 4, 2017 (Between 10:00pm and 10:30pm)
Method of Transportation: School Bus
Cost: $5

Overview:
9:00am – Meet in Larkin Hall
Social Component: Throughout the day
Service Component (2 hours): Community Foodbank of NJ (31 Evans Terminal, Hillside, NJ)
Educational Component: Archdiocesan Youth Center (499 Belgrove Dr., Kearny, NJ)
Spiritual Component: Catholic Underground @ Our Lady of Good Counsel (230 E 90th St, New York, NY)
10:00/10:30pm – Pick up in Larkin Hall (Youths will call when leaving NYC to confirm pick up time)

** Youth Group shirts must be worn and may be purchased for $15.
** Teens should bring a bagged lunch. Dinner will be provided.
** 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 Service Day Retreat #2 (Foodbank & NYC) Locations: (See below)
Designated Supervisor of Activity: Lee Ann Rivera
Meeting Date and Time: Saturday, Nov. 4, 2017 (9:00am)
Pick-up Date and Time: Saturday, Nov. 4, 2017 (Between 10:00pm and 10:30pm)
Method of Transportation: School Bus
Cost: $5

Overview:
9:00am – Meet in Larkin Hall
Social Component: Throughout the day
Service Component (2 hours): Community Foodbank of NJ (31 Evans Terminal, Hillside, NJ)
Educational Component: Archdiocesan Youth Center (499 Belgrove Dr., Kearny, NJ)
Spiritual Component: Catholic Underground @ Our Lady of Good Counsel (230 E 90th St, New York, NY)
10:00/10:30pm – Pick up in Larkin Hall (Youths will call when leaving NYC to confirm pick up time)

** Youth Group shirts must be worn and may be purchased for $15.
** Teens should bring a bagged lunch. Dinner will be provided.
** 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.