Youth Ministry Registration 2023-2024
Please complete the below registration form in order to participate in youth group activities.
Family Section
Information and Contact Info about family unit
Mother/Guardian Name
First Name
Last Name
Mother/Guardian Cell Phone Number
-
Area Code
Phone Number
Mother/Guardian Email
example@example.com
Father/Guardian Name
First Name
Last Name
Father/Guardian Cell Phone Number
-
Area Code
Phone Number
Father/Guardian Email
example@example.com
Primary Address of Teens
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Address Phone Number
-
Area Code
Phone Number
Secondary Address of Teens (if applicable)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Secondary Address Phone Number (if applicable)
-
Area Code
Phone Number
Please indicate which phone number is preferred contact for youth ministry related issues
*
-
Area Code
Phone Number
Please indicate which email address is preferred contact for youth ministry related issues
*
example@example.com
Please describe any custody related issues (most recent court order should be supplied to youth minister as soon as possible).
We strongly encourage teens to participate in the ministry roles for 6pm Mass. Please indicate which roles your teens would like to partake in.
Altar Server
Lector
Usher
Gift Bearer
Choir
Teen Section
Information and Contact Info about youth group participants. Please answer a separate teen section for each participating teen in your family.
Teen Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
School Name
Grade (2023-2024 School Year)
Freshmen
Sophomore
Junior
Senior
College
Adult (21+)
8th Grade
7th Grade
T-shirt Size
Small
Medium
Large
XL
XXL
Does this teen have a maroon youth group t-shirt?
Yes!
No, never received one.
No, lost it.
Yes, but would like a new one (Cost: $15).
This teen has received Baptism, Reconciliation, Eucharist, and Confirmation.
Yes
No
If no, please specify which sacraments the teen has not received, and whether there is plan to have the sacraments administered to the teen.
Teen Cell Phone
-
Area Code
Phone Number
I give permission for the youth ministry to contact my teen by cell phone.
Yes
No
Teen Email Address
example@example.com
I give permission for the youth ministry to contact my teen by email address.
Yes
No
Teen Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
School Name
Grade (2023-2024 School Year)
Freshmen
Sophomore
Junior
Senior
College
Adult (21+)
8th Grade
7th Grade
T-shirt Size
Small
Medium
Large
XL
XXL
Does this teen have a maroon youth group t-shirt?
Yes!
No, never received one.
No, lost it.
Yes, but would like a new one (Cost: $15).
This teen has received Baptism, Reconciliation, Eucharist, and Confirmation.
Yes
No
If no, please specify which sacraments the teen has not received, and whether there is plan to have the sacraments administered to the teen.
Teen Cell Phone
-
Area Code
Phone Number
I give permission for the youth ministry to contact my teen by cell phone.
Yes
No
Teen Email Address
example@example.com
I give permission for the youth ministry to contact my teen by email address.
Yes
No
Teen Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
School Name
Grade (2023-2024 School Year)
Freshmen
Sophomore
Junior
Senior
College
Adult (21+)
8th Grade
7th Grade
T-shirt Size
Small
Medium
Large
XL
XXL
Does this teen have a maroon youth group t-shirt?
Yes!
No, never received one.
No, lost it.
Yes, but would like a new one (Cost: $15).
This teen has received Baptism, Reconciliation, Eucharist, and Confirmation.
Yes
No
If no, please specify which sacraments the teen has not received, and whether there is plan to have the sacraments administered to the teen.
Teen Cell Phone
-
Area Code
Phone Number
I give permission for the youth ministry to contact my teen by cell phone.
Yes
No
Teen Email Address
example@example.com
I give permission for the youth ministry to contact my teen by email address.
Yes
No
Medical Information
Please provide pertinent medical information. Please specify teen name with this information if registering multiple teens.
Please indicate any medical conditions, allergies, or dietary restrictions that we should know about (Please type N/A if none apply).
*
Please list type, dosage, and frequency of current medications (Please type N/A if none apply).
*
I permit this teen to receive Tylenol if requested (list name below, type N/A if not applicable)
*
I DO NOT permit this teen to receive Tylenol if requested (list name below, type N/A if not applicable)
*
Please indicate any special needs/ mental health needs/ diagnoses/ accommodation requests that we should know about (Please type N/A if none apply)
*
Permissions
I understand that only adults 21 or older with complete background checks and required Archdiocesan training can participate in a leadership role within the youth ministry. I understand that limited "junior" leadership roles are given to adults from the ages of 18-20 with complete background checks and required Archdiocesan training.
*
I have read and understand this statement.
Photo/Video Permission: I give my permission for Corpus Christi Youth group to use pictures and videos of my child for the use of advertising and promotional use within the Parish and on certain social media sources such as Facebook,Twitter, Youtube, and on posters and local Parish videos.
*
Yes
Transportation Clause: I give permission for approved chaperones, and Youth Minister to drive my child(ren) to and from events with the Youth Group.
*
Yes
Liability Statement and Medical Permission: Knowing that there will be proper supervision, in case of injury, I will not hold Corpus Christi Parish or the Archdiocese of Philadelphia or any person or persons connected with them liable. I give permission that, in my absence, my children whose names appear on this form may receive emergency medical care for injuries and situations that should occur while participating in Corpus Christi High School Youth Ministry.
*
Yes
I agree that, in order for my teen(s) to participate in youth group, they must abide by rules and regulations put forth by the parish and youth ministry, including any guidelines involving prevention of CO-VID 19.
*
Yes
I agree to the youth ministry's one-time payment of $15 as membership dues, to be provided when possible.
*
Yes
I need to discuss this.
I paid dues during a previous year.
My signature below indicates that the information I have provided is true and complete to the best of my knowledge, and that I have read, understand, and agree to the statements above as indicated by my selected responses and my signature below.
*
I have read and understand this statement.
Guardian Name
*
First Name
Last Name
Guardian Signature
*
Submit
Should be Empty: