EmailMe Form - 2021 OLV Youth Group Registration

Texting and Social Media

Flock note sign up

The youth program communicates information through flock notes, therefore it is very important for families to join in order to stay updated on current events and any event changes. The option to receive information via email, text or both is available.

Please sign up for Flock Note: Text OLOV to 84576

Please be sure to add yourself to the “parent” group under your child/children’s youth program (sign up for high school and middle school if you have children in both), as well as sign your student up for the “high school” or “middle school” group under the same category.

I have signed up for Flock Note: *

Yes

No

I understand that my teen’s contact information will be used to contact them via Flocknote or Work Cell Phone about youth group related information. *

Yes

I would like to be included in text about Youth Group Information *

Yes

No

Is your family registered at Our Lady of the Valley Catholic Church? *

Yes

No

If no, where are you registered?

STUDENT INFORMATION

1. Students Name *

First Last

Gender:

Male

Female

I am signing up for *

Middle School

High School

If Middle School - Which evening will your child attend Youth Group? *

Wednesdays, 5:45 - 7:15

Thursdays, 5:45 - 7:15

If High School - Please register and details will be sent out the week of Sept 1st

Please send me HS details

We are interested in a small group bible study

High School Hang Outs will be held on Thursdays from 8-9:30

Student Phone

### - ### - ####

Student Email: *

Birthdate: *

MM / DD / YYYY

Grade: *

School Attending *

Sacraments student has received: *

Student food allergies/special needs

Student lives with: *

Both Parents

Mother

Father

Other

PRIMARY PARENT/GUARDIAN INFORMATION: *

First Last

PRIMARY PARENT/GUARDIAN ADDRESS: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

PRIMARY PARENT/GUARDIAN CONTACT PHONE: *

### - ### - ####

PRIMARY PARENT/GUARDIAN EMAIL ADDRESS:

2ND PRIMARY PARENT/GURADIAN

First Last

2ND PRIMARY PARENT/GUARDIAN CONTACT PHONE:

### - ### - ####

2ND PRIMARY PARENT/GUARDIAN EMAIL ADDRESS:

EMERGENCY CONTACT: *

First Last

EMERGENCY CONTACT PHONE:

### - ### - ####

Additional Students

I have two or more students to register *

No

Yes

2. Students Name

First Last

Gender:

Male

Female

I am signing up for

Middle School

High School

If Middle School - Which evening will your child attend Youth Group? *

Wednesdays, 5:45 - 7:15

Thursdays, 5:45 - 7:15

If High School - Please register and details will be sent out the week of Sept 1st

Please send me HS details

We are interested in a small group bible study

High School Hang Outs will be held on Thursdays from 8-9:30

Student Phone

### - ### - ####

Student Email:

Sacraments student has received:

Birthdate:

MM / DD / YYYY

Grade:

School Attending

2. Student food allergies/special needs

2. Student lives with:

Both Parents

Mother

Father

Other

2. Student Guardian/Address is same as above:

Yes

No

2. PRIMARY PARENT/GUARDIAN INFORMATION:

First Last

2. PRIMARY PARENT/GUARDIAN ADDRESS:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

2. PRIMARY PARENT/GUARDIAN CONTACT PHONE:

### - ### - ####

2. PRIMARY PARENT/GUARDIAN EMAIL ADDRESS:

3. Students Name

First Last

Gender:

Male

Female

I am signing up for

Middle School

High School

If Middle School - Which evening will your child attend Youth Group? *

Wednesdays, 5:45 - 7:15

Thursdays, 5:45 - 7:15

If High School - Please register and details will be sent out the week of Sept 1st

Please send me HS details

We are interested in a small group bible study

High School Hang Outs will be held on Thursdays from 8-9:30

Sacraments student has received:

Student Phone

### - ### - ####

Student Email:

Birthdate:

MM / DD / YYYY

Grade:

School Attending

Student food allergies/special needs

3. Student lives with:

Both Parents

Mother

Father

Other

3. Student Guardian/Address is same as above:

Yes

No

3. PRIMARY PARENT/GUARDIAN INFORMATION: *

First Last

3. PRIMARY PARENT/GUARDIAN ADDRESS:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

3. PRIMARY PARENT/GUARDIAN CONTACT PHONE:

### - ### - ####

3. PRIMARY PARENT/GUARDIAN EMAIL ADDRESS:

4. Students Name

First Last

Gender:

Male

Female

I am signing up for

Middle School

High School

If Middle School - Which evening will your child attend Youth Group? *

Wednesdays, 5:45 - 7:15

Thursdays, 5:45 - 7:15

If High School - Please register and details will be sent out the week of Sept 1st

Please send me HS details

We are interested in a small group bible study

High School Hang Outs will be held on Thursdays from 8-9:30

Sacraments student has received:

Student Phone

### - ### - ####

Student Email:

Birthdate:

MM / DD / YYYY

Grade:

School Attending

Student food allergies/special needs

4. Student lives with:

Both Parents

Mother

Father

Other

4. Student Guardian/Address is same as above:

Yes

No

4. PRIMARY PARENT/GUARDIAN INFORMATION: *

First Last

4. PRIMARY PARENT/GUARDIAN ADDRESS:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

4. PRIMARY PARENT/GUARDIAN CONTACT PHONE:

### - ### - ####

4. PRIMARY PARENT/GUARDIAN EMAIL ADDRESS:

SIGNATURE

*I hereby acknowledge that I am the parent or legal guardian of the above child and give him/her my permission to participate inactivities planned at Our Lady of the Valley Catholic Church and locations within the local area during the scheduled program times and dates. I 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 I will not hold Our Lady of the Valley Catholic Church, the Archdiocese of Denver, any volunteer, chaperone, or driver responsible. I 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 State of Colorado. The undersigned understands and agrees that any medical, dental, or hospital expenses incurred shall be at his/her own expense. The undersigned understands every effort will be made to notify the emergency contact in the event that treatment is necessary.

Signature: *

Our Lady of the Valley Photographic & Interview Release

I hereby grant permission for the above child/children to be photographed or videotaped and give my permission for his/her picture to be published for the purpose of promoting programs at Our Lady of the Valley Catholic Church, on our website and social media.

I hereby decline to grant permission for my child/children to be photographed or videotaped. I have instructed my child to decline being photographed or videotaped at all times and have instructed my child to notify directors, coordinators, catechists, and other volunteers that he/she may not be photographed or videotaped under any circumstances.

Photographic/Interview Consent *

I hereby grant permission

I hereby decline permission

Signature: *

Any Additional Comments or notes for our staff: