Catholic VBS – A Radical Ride On the Wings of Prayer
Get onboard Cat.Chat Airlines and takeoff on a Radical Ride around the world with Amazing Angels and Super Saints. Buckle up as you prepare to learn some awesome lessons about prayer and how to put it into action!
The overall goals for this program are to help the children learn more about prayer and how to put it into action. “Pray! Pray, but with faith – with living faith! Courage! Onward, ever onward!” – St. John Bosco
WHO: All youth ages 3 years old to 6th grade
WHEN: August 6th to August 10th from 5:30 p.m. to 8:30 p.m.
Supper will be served each night
WHERE: St. Francis Xavier Parish Hall
214 Juniatta
Burlington, KS 66839
For more information or to volunteer, contact Kara Reynolds at 620-490-0054 or , or the St. Francis Xavier Parish Office at 364-5671. Open to all youth in all four parish communities.
Registration, Agreement & Consent for
Vacation Bible School
Sunday – August 6th to Thursday - August 10th, 2017
5:30pm – 8:30pm
St. Francis Xavier Catholic Church, Burlington, KS
Registration Form:
Name: Grade:
Address:
Parish:
Name of Parent(s)/Guardian(s):
Best Contact Number:
Email Contact Information:
Youth Agreement for all students 10yrs of age and older:
It is expected that both students and parents make a sincere commitment to this event. The cooperation of each individual in the group is imperative. It is, therefore, necessary to establish a policy that encourages positive behavior and cooperation.
The atmosphere of this event will be open and interactive. This necessitates that the student will be considerate and respectful to everyone that they encounter. Expecting an acceptable quality of behavior allows for the spiritual growth of all who are involved in the program.
The procedure to maintain a positive environment is as follows:
I will be respectful, courteous, and considerate of all those attending the event and those that are helping to facilitate the event.
I will refrain from being disruptive with regard to the following:
· Attitude
· Behavior (i.e. bullying)
· Comments made to or about another individual
· Cell phone usage
First, if my behavior is found to be disruptive, I will be asked to change said behavior.
Second, if my behavior continues to be disruptive, I will be asked to remove myself from the location of others so the disruption can be minimized.
Finally, if my behavior continues to be a disruptive problem, I will be asked to notify my parent(s) or guardian(s) that I can no longer attend the event and will need to be removed from the premises.
Youth’s Printed Name:
Youth’s Signature: Date:
Parental Consent Information:
I, , request and give permission for my son/daughter,
, to participate in Vacation Bible School at St. Francis Xavier Catholic Church from Sunday – August 6 to Thursday - August 10, 2017 from 5:30pm – 8:30pm each evening.
In consideration for permitting my child to participate in this event, I agree on behalf of my child and myself, our heirs, assigns, executors and personal representatives to release and hold harmless the DRE’s, youth ministers, assistants, coordinators, chaperones and volunteers from St. Francis Xavier Catholic Church, Burlington, Kansas; St. Joseph, Waverly; and St. Teresa, Westphalia and the Roman Catholic Archdiocese of Kansas City in Kansas, their officers, directors, agents, employees, sponsors, aides, chaperones and official representatives from any and all liability, claims, loss or damages arising from or in connection with my child’s participation in this event.
In the event of sickness or accident, the adults supervising the event have my permission to secure medical care for my child. I hereby release the youth ministers, assistants, coordinators, chaperones and volunteers from St. Francis Xavier Catholic Church, Burlington, Kansas; St. Joseph, Waverly; and St. Teresa, Westphalia and the Roman Catholic Archdiocese of Kansas City in Kansas, their officers, directors, agents, employees, sponsors, aides, chaperones and official representatives and all others connected with the event from any and all claims arising out of or from any accident or other occurrence, causing injury to any person or property during this event.
I also understand that in the event my child is dismissed from this event for any reason, I am responsible for his/her transportation home. I hereby warrant that, to the best of my knowledge, my child is in good health, and I assume all responsibility for his/her health.
Parent / Guardian Printed Name:
Parent/ Guardian Signature: Date:
Emergency Contact Information:
In case of an Emergency contact:
Relationship to student attending:
Parent/Guardian Signature
Phone Contact Number: ______
Cell Phone Contact Number: ______
Allergies known (including food):
Medications being taken at this time:
My child may be given OTC medications such as Tylenol, Advil, Tums/Rolaids, Pepto Bismol,
After Bite Sting Medication, etc.: Yes No
Photograph and Video Consent Form
From time to time, pictures and video may be taken of CCD, youth ministry events and parish gatherings. We would like to be able to use these photographs and videos for flyers, parish and diocesan publications, the ministry website and possibly the local newspaper. Written consent of both the student and parent/guardian is required. Names will not be posted unless written authorization is given by the student and parent/guardian, and then only first names will be used unless consent for full name is given. If there are concerns about pictures or videos posted on the website, please contact your parish ministry coordinator, the main office, or Father directly and they will promptly be removed.
I/We, the parent(s)/guardian(s) of this youth ______
Print name
authorize and give full consent, without limitation or reservation, to ______
Print parish
to publish any photograph or video in which the above named student appears while
participating in any program associated with ______parish
Print parish
ministry. There will be no compensation for use of any photograph or video at the time of
publication or in the future.
Please mark only one:
____ When a photograph or video is used of the above listed youth, NO Name will be used to
distinguish youth. Only ‘participant’ will be used for identification.
____ When a photograph or video is used of the above listed youth, First Name ONLY will be
used to distinguish youth for identification.
____ When a photograph or video is used of the above listed youth, Full Name MAY BE used
to distinguish youth for identification.
Student Signature:______Date:______
Parent/Guardian Signature:______Date:______
Parent/Guardian Printed Name: ______
Parent/Guardian Signature:______Date:______
Parent/Guardian Printed Name: ______