St. B's Youth: New Youth Registration '23-24

Family Information

Parent and Guardian #1 Name

Parent and Guardian #1 Phone

Parent and Guardian #1 Email

This address will receive a confirmation email

Parent and Guardian #2 Name

Parent and Guardian #2 Phone

Parent and Guardian #2 Email

Youth's Name

Youth's Phone

Youth's Address

What is the best way to contact your youth?

Youth's Birthday

Grade

7th 8th 9th 10th 11th 12th

What school do they currently attend?

Are there any emotional, physical, and other needs that we need to be aware of to best serve your youth?

What name would they like on their church name tag?

Safety and Wellness

Please include an Emergency Contact that is in addition to parents and guardians.

Emergency Contact's Name

Emergency Contact's Phone

Emergency Contact’s Relationship to the Youth

Are there any persons that are not allowed to transport your child?

Are there any health concerns, allergies, or anything else we need to be aware of? Please list all conditions, symptoms, allergies, and medications.

Primary Care Physician’s Name

Primary Care Physician’s Telephone Number

Dentist’s Name

Dentist’s Telephone Number

If the event is local, do you have a preferred hospital?

Insurance Information

Insurance Provider:

Group Number:

Identification Number:

Name of the Individual the Insurance is under:

Insurance Holder's Date of Birth

Community Agreement

St. B’s Youth Formation is dedicated to being a safe place for everyone to become mature followers of Christ. To do that, we hold community expectations to help safeguard those experiences:

Be respectful to peers, leaders, property, and yourself.

No teasing, negative language, taunting, pranks, or bullying. Look out for those who might feel uncomfortable or unable to connect with the group.

Technology is an important way we connect with one another and build community. Limit electronic usage when it limits conversation or awareness of the situation around you.

No weapons, drugs, vapes, e-cigs, or alcohol are allowed during our programming.

Follow all posted signs and leader instructions stated in all signup materials and information, verbal communications, and printed signs.

Be a peacemaker in all interactions. Look for common ground to unite us with one another.

Ask for help when needed. We are committed to helping one another when asked and respect your agency to solve problems. If a situation includes harm to yourself or/and others or/and someone is harming you, talk to DYF or an adult leader immediately. Safety is our primary goal in all interactions.

Do you agree to these terms?

Yes, we agree.

St. B's Photo Policy

Most of these photos appear on the TV in the lobby, in-house posters, and brochures. Photos are also used on our social media accounts, in emails, and on our website.

When using photos:

o We use large group, action, and wide-angle shots whenever possible.

o We seek permission before using small group photos with faces clearly visible on social media.

o We never list children’s names by a photo, nor tag them on social media.

We completely respect that some families do not want photos of their children being taken and used in various church publications.

A family may opt-out at any time by signing below.

Would you like to:

Opt out of my child's photo being taken or used. It's okay to use my child's photo.

Description

Thank you for registering your youth to participate in youth-sponsored activities here at St. B’s from August 2023 to July 2024! This form includes our Sunday Formation Hour, classes (such as Confirmation or a Bible Study), youth-sponsored events where parents are not present in the room, or regularly scheduled meetings sponsored by the church at a public off-site location. All other events will have a unique permission form based on the nature of the event.

By filling out this form, you will be added to our monthly emailed newsletter and event text messages to keep you informed about youth activities.

Information provided is shared among pastoral staff and held in confidence. If there is information that might benefit your youth’s leaders to serve them better, we will reach out to you for express permission to share that with those leaders.

Fill out this form for EACH youth in your family.

St. B's Youth: New Youth Registration '23-24

Description

Please Fix the Following