ELEMENTARY & YOUTH PROGRAMS 2018-2019 Parish: Church of the Redeemer Participant’s Name: Sex: Date of Birth: Parent’s (or Legal Guardian’s) Name: Home Address: City: State: Zip: Home #: Work #: Cell #: I, , grant permission for my child, to participate in religious education and youth , ministry events at the parish from June 1, 2018 - Aug. 31, 2019, including but not limited to formation classes and Vacation Bible School. I understand that these events will take place under the guidance and direction of parish employees and/or volunteers. A separate form will be provided for off-site events. As parent/legal guardian, I remain legally responsible for any personal action taken by my child. I agree to hold harmless Church of the Redeemer and the Diocese of Richmond as well as its officers, directors, agents, chaperons, or representatives associated with these events, arising from or in connection with my child attending the event, including but not limited to accidents, emergencies, or exposure to reckless conduct of persons. Parent (or Legal Guardian) Signature: ________________________________________ Date _____________________ PHOTO RELEASE: Occasionally, photos of events may appear on the church website and/or in printed materials such as the parish newsletter. No identifying information will accompany the images. I grant permission to Church of the Redeemer to photograph my child and use his/her picture, silhouette, or other reproductions of physical likeness in connection with publications (i.e. newsletters, website, brochures), video recordings or news releases of Church of the Redeemer. Yes No Parent (or Legal Guardian) Signature: ________________________________________ Date _____________________
ELEMENTARY & YOUTH PROGRAMS 2018-2019 Parish: Church of the Redeemer Participant’s Name: Sex: Date of Birth: Parent’s (or Legal Guardian’s) Name: Home Address: City: State: Zip: Home #: Work #: Cell #: I, , grant permission for my child, , to participate in religious education and youth ministry events at the parish from June 1, 2018 - Aug. 31, 2019, including but not limited to formation classes and Vacation Bible School. I understand that these events will take place under the guidance and direction of parish employees and/or volunteers. A separate form will be provided for off-site events. As parent/legal guardian, I remain legally responsible for any personal action taken by my child. I agree to hold harmless Church of the Redeemer and the Diocese of Richmond as well as its officers, directors, agents, chaperons, or representatives associated with these events, arising from or in connection with my child attending the event, including but not limited to accidents, emergencies, or exposure to reckless conduct of persons. Parent (or Legal Guardian) Signature: ________________________________________ Date _____________________ PHOTO RELEASE: Occasionally, photos of events may appear on the church website and/or in printed materials such as the parish newsletter. No identifying information will accompany the images. I grant permission to Church of the Redeemer to photograph my child and use his/her picture, silhouette, or other reproductions of physical likeness in connection with publications (i.e. newsletters, website, brochures), video recordings or news releases of Church of the Redeemer. Yes No Parent (or Legal Guardian) Signature: ________________________________________ Date _____________________