Please provide the following information:

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* 1. Please provide the following information:

I, the parent/guardian listed above, grant permission for my child(the participant listed above) to participate in youth ministry meetings.  I understand that meetings will take place under the guidance and direction of parish employees and/or volunteers from the parish.  Please check which events your participant will attend.  Please select all if there will be able to ever attend any of the following.

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* 2. I, the parent/guardian listed above, grant permission for my child(the participant listed above) to participate in youth ministry meetings.  I understand that meetings will take place under the guidance and direction of parish employees and/or volunteers from the parish.  Please check which events your participant will attend.  Please select all if there will be able to ever attend any of the following.

We are asking parents/guardians to be more involved with Youth Ministry this year.  Please indicate which areas you would be willing to help.

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* 3. We are asking parents/guardians to be more involved with Youth Ministry this year.  Please indicate which areas you would be willing to help.

I also allow the participant listed above to have photos taken of them.  I understand that the photo's taken may be posted on social media sites.  I am aware of the St. Therese Youth Ministry Facebook page and Instagram account.  I acknowledge that I have been informed of the handler names so I may follow if I so choose.

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* 4. I also allow the participant listed above to have photos taken of them.  I understand that the photo's taken may be posted on social media sites.  I am aware of the St. Therese Youth Ministry Facebook page and Instagram account.  I acknowledge that I have been informed of the handler names so I may follow if I so choose.

I, certify that as the parent/legal guardian of the participant listed above, I remain legally responsible for any personal action taken by my child.  I agree to hold harmless the Church of St. Therese and the Diocese of Richmond as well as its officers, directors, agents, chaperones, or representatives associated with this event, arising from or in connection with my child attending this event, or including but not limited to accidents, emergencies, exposures to reckless conduct of persons.  I also understand that if any medical changes occur during this time frame, I am responsible for updating my medical release form with the parish.  I understand that submission of my name, parishioner number, and today's date constitutes a legal and binding electronic signature.

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* 5. I, certify that as the parent/legal guardian of the participant listed above, I remain legally responsible for any personal action taken by my child.  I agree to hold harmless the Church of St. Therese and the Diocese of Richmond as well as its officers, directors, agents, chaperones, or representatives associated with this event, arising from or in connection with my child attending this event, or including but not limited to accidents, emergencies, exposures to reckless conduct of persons.  I also understand that if any medical changes occur during this time frame, I am responsible for updating my medical release form with the parish.  I understand that submission of my name, parishioner number, and today's date constitutes a legal and binding electronic signature.

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