Life Teen Registration

*Denotes Required Field * Title

Teen Information

* First Name

* Last Name

* Email

* Grade

School

Birthdate

Mailing Address

Parent / Guardian Information

* Parent/Guardian Contact 1 Name

* Contact 1 Phone Number ( ) -

* Contact Email

* Relation to teen

Medical and Media Release

* Please list any known allergies/dietary restrictions or health concerns we should be aware of

* Are there any special needs or considerations we should be aware of (e.g., learning or physical disabilities, reading difficulties, hearing impairments, emotional concerns, etc.)? This information is not asked to exclude anyone, but rather to help us support and include each person more fully.

I/We understand that reasonable precaution will be taken to safeguard the health and safety of the participant and that 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 Isaac Jogues, 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. 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 emergency contact in the event that treatment is necessary.

* I agree

I hereby grant permission for my child to be photographed and/or videotaped during EDGE/Alpha Youth Activities and events. I understand that my child may decline to be photographed and/or videotaped at any time. I further grant permission for the resulting photographs and/or videotaped footage to be edited, if necessary, and then published and/or used for the purpose of promoting The EDGE, Alpha Youth and/or any other youth programs at St Isaac Jogues Parish.

* I agree

There is no fee to register for Life Teen. We operate on the generous donations of our parishioners which helps cover materials and dinners. If you would like to make a donation towards the Life Teen program, please do so on the Life Teen page of the parish website.

Should you have any questions, please contact the Youth Minister, Meagan, at youthministry@stisaacjogues.ca. Thank you and God bless!