World Youth Day @ 6 Flags - Parent Consent / Release Form

 

I hereby authorize my Son/Daughter to participate in our trip to Six Flags / World Youth Day to be held on October 29, 2006, with St. Andrew Kim Catholic Church, Dallas, TX.  I understand reasonable precautions will be taken to keep my child safe. I will not hold St. Andrew Kim Catholic Church, Father Joe Lee, Yong Oh, Dennis Kang, or any volunteers responsible for accidental harm or injury that may occur during this activity. In case of an emergency during this time, I hereby consent to and authorize the giving of treatment and/or medication ordered by a physician or adult for the care of my Son/Daughter.

 

Youth Name                                                                          Age                                        D.O.B.                                   

 

 

Physician’s Name                                                                                                Phone                                                    

 

 

Preferred Hospital                                                                                                                                                               

 

 

Medical Insurance Co. Name                                                      Ins. Co. Phone                                                     

 

 

Policy #                                                                                 

 

 

Student Medications & Allergies, if any ____________________________________________________

 

 

Parent Emergency contact number                                                   

 

St. Andrew Kim Youth Ministry “10 Commandments”

  1. I will always uphold my Catholic faith at all youth event.
  2. I agree to treat other participants, leaders, staff, and residents with respect and understand that all adult leaders have the authority to discipline me.
  3. I will always follow the schedules and guidelines given to me.
  4. I understand that I represent St. Andrew Kim Catholic Church and agree to behave in a Christian and positive manner at all times. I further agree to dress appropriately during this event.
  5. I understand that alcohol, weapons, fireworks, tobacco products of any kind, illegal drugs and profane or abusive language are NOT allowed at any time during this activity.
  6. Sexual indiscretion (both verbal comments and inappropriate touching) is prohibited at all times and in all cases.
  7. In the event of an emergency or any other need to contact me, I agree to stay with my assigned group at all times.
  8. I realize that I, and my parent(s) will be financially responsible for any damage I do to others’ property, facilities, or vehicles.
  9. I understand that if I choose to violate any part of the “10 Commandments,” I run the risk of having my parents notified by phone, and that I will be sent home at my parents’ expense.
  10. I promise to HAVE FUN at all times!

 

Youth Signature                                                                      Date:                           

 

Parent Signature                                                                      Date:                           

                                               

$25 without lunch / $32 with lunch

Meet at church by 9:30am and return 9:00 pm.                  (Circle each for ride situation)        

Bring xtra money for drinks & snack/lunch/dinner.    Drop Off Child at 6 Flags:     N      or   Y 

Money and permission slip due by Oct. 22nd!!                  Pick Up Child at 6 Flags:      N     or    Y