EmailMeForm
Alive In You Summer Camp 2024
Catholic Archdiocese of Atlanta
All Saints Catholic Church
June 25-30, 2024
Total Cost: $550
Nonrefundable Deposit: $100
* Due at the time of registration
Registration Deadline: Mar. 17th, 2024
* Participants who drop out after this date will be held responsible for the full cost of the retreat.
*** Student's INFORMATION ***
Name of Student
*
First
Middle
Last
Nickname
Grade
*
9th - Grad 2028
10th - Grad 2027
11th - Grad 2026
12th - Grad 2025
Grad! - 2024
Birthday
*
MM
/
DD
/
YYYY
Teen's age
*
Age of teen when they will be at Camp
Gender
*
Male
Female
Do you give our Youth Director permission to contact your teen directly?
*
No – I do not give you permission to contact my teen
Yes – by phone and email
Yes – only by phone
Yes – only by email
Youth's Email
Youth's Phone Number
*
###
-
###
-
####
Name of School
*
Blessed Trinity Catholic HS
Chamblee Charter
Dunwoody High School
Greater Atlanta Christian School
King's Ridge Christian School
Marist
Norcross High School
North Springs Charter High
Notre Dame Academy
Saint Francis
Shamble High School
St. Pius X
Wesleyan School
Regina Caeli Academy Homeschool Hybrid
Home School
Other
Other School Name
If your school name wasn't listed please type here.
Teen's Favorite Snacks
*
Side Notes
Anything we should know about your teen that can help us journey with him/her in the faith.
*** Parents/Guardian INFORMATION ***
Primary Parent/Guardian's Name
*
First
MI
Last
Primary Parent/Guardian's Email
*
Primary Parent/Guardian's Phone Number
*
###
-
###
-
####
*** Travel Information ***
Nashville, TN
Individuals in Charge:
Jessica Duron & Jesse Butrum
All Saints Catholic Church
Drop off time: TBA Tues. June. 25th, 2023
Pick Up time: TBA Sun. June. 30th, 2023
Mode of Transporation to and from the event: Carter Bus
*** MEDIA RELEASE FORM ***
REF ID#: YP-MEDIA-04302013.14
Our parish, All Saints Catholic Church, uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels; social networking platforms including but not limited to Facebook, Twitter,
and Instagram.
We follow the Archdiocese of Atlanta’s Social Media Policy and Guidelines for the Use of Social Networking Sites with
Minors. Please see this resource for more information.
Please indicate below whether our parish and/or school has permission to circulate interviews, images, and/or videos of your child for all parish and/or school events for one year: *
*
NO, I do not want my child included in, nor my child’s image used, in any internal or external communications.
I hereby grant permission for the following parish, All Saints Catholic Church, to use images and interviews of my child and/or children, for internal or external communications for one year.
My child may be photographed and/or interviewed for The Georgia Bulletin, and other media outlets. I understand content may be reprinted in The Georgia Bulletin or other media for public dissemination, including but not limited to film; video; television; radio; newspapers such as The Atlanta Journal and Constitution; websites and online platforms; and social media networks including but not limited to Facebook, Twitter, and Instagram. I release and relieve the parish and/or school, and the Archdiocese of Atlanta, from any responsibility or liability for any claims arising from the publication or reproduction of any photographs or interview in any news or other media. I waive any and all right to inspect or approve the finished images, video, or printed matter that may be used in conjunction with any image or video, or to approve the eventual use for which it may be applied. I understand that photographs, videos, and/or interviews are being done with the knowledge and approval of the parish and/or school, and that a signed release form is required for every participating individual.
*** ASSUMPTION OF THE RISK RELATING TO COVID-19 ***
REF ID#: YP-COVID-04302013.14
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person to person through respiratory droplets when an infected individual cough, sneezes, or speaks. As a result, government agencies at all levels and federal, state, and local health agencies recommend social distancing and have placed limits on the congregation of groups of individuals.
All Saints Catholic Church has put preventative measures in place to reduce the spread of COVID-19; however, the parish cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending activities on the campus of All Saints Catholic Church could increase your risk and that of your children for contracting COVID-19.
While All Saints Catholic Church/youth group will make all reasonable efforts to lower the risk of COVID-19 exposure and spread at the parish, the parish is unable to provide any guarantee that students or their families will not be exposed to or infected by COVID-19.
By enrolling your child(ren) in and attending parish faith formation, you acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that you, your child(ren), and or other family members may be exposed to or infected by COVID-19. It is expected that students and other family members will follow the preventative measures and guidelines implemented by All Saints Catholic Church/youth group including not coming to the parish premises if demonstrating any signs or symptoms of COVID-19.
Signature of Parent or Legal Guardian
*
Clear
Date Time
*
MM
/
DD
/
YYYY
*** Teen's agreement ***
I agree to abide by any / all policies and rules established for this event / activity. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent’s expense.
Basic rules / expectations include, but are not limited to, the following: Respect for all adult leaders, peers, and all property; NO illegal drugs, alcohol, underage smoking, firearms, explosives, or other illegal substances; Males and females are to remain in separate sleeping spaces at all times; No inappropriate physical / sexual activity; Appropriate attire is to be worn at all times. Other guidelines may be set forth accordingly by adult chaperones present for the event(s).
Teen Signature
*
Clear
Date Time
MM
/
DD
/
YYYY