PARENT and PARTICIPANTS’INFORMATION
Dear Parent or Legal Guardian:
Your son/daughter is eligible to participate in a parish/school sponsored activity requiring transportation to a location away from the school/parish premises. This activity will take place under the guidance and supervision of authorized personnel from your parish.
Name of Event: Diocese of SaginawMYE Faith Youth Rally: HOPE 2013
Location: On the campus of SaginawValleyStateUniversity
Date of departure and return: Saturday, August 10, 2013
Method of Transportation: ****[PARISH CARPOOL, BUS, ETC.]****
Designated Supervisor: ****(CONTACT NAME)(PARISH)****
Cost: $50 per person
Emergency Contact during event: ****(CONTACT NAME) (CONTACT NUMBER)****
If you would like your child to participate in this event, please complete, sign, and return the following statement of consent and release of liability. As parent or legal guardian, you remain fully responsible for the actions and conduct of your child. If the youth leave the premises for any reason, they will be sent home.
MYEFAITH: HOPE 2013 TENTATIVE AGENDA
7:30 AMRegistration Opens/ MET Team
9:30 AMKeynote: Fr. Tony Ricard
10:45 AMKeynote: Sarah Hart
11:45 AM Lunch –YouthTown Opens
12:30 PMBreakout Sessions (staggered) and
Reconciliation, Adoration, God time
4:30 PMDinner
5:30 PM MET Team
7:00 PMMass
9:15 PMMET Team
9:30 PMMatt Maher Concert
11:45 PMConcessions close
Breakout Sessions
- Daughters of the Father–Amanda Vernon: As young women, we are daughters of the Father, disciples of Christ, and a symbol of the Church. Claim the truth of Christ, and the freedom to be who we are called to be.
- Wonderfully Made– Noelle Garcia: Describing herself as the original "Ugly Betty," Noelle shares her struggles with self-image, depression, cutting, and suicidal thoughts as a teenager. Hear how God healed her wounds.
- Set the World on Fire– Noelle Garcia: "When you are who you are called to be, you will set the world ablaze" (St. Catherine of Siena). Learn how to truly be yourself and embrace what YOU are called to do!
- Grief and Depression – This workshop will focus on how to find God's love and hope in difficult times in our lives. We will also learn how to be a true friend when someone we love is going through their tough times.
- Evangelization– Kevin Wojciechowski: Do you have the desire to share the Good News about Jesus' life? Learn how you are the perfect person to share the Gospel with your family and friends.
- Bishop Roundtable– Most Reverend Joseph R. Cistone, D.D.: Bishop Cistone will listen and respond to questions about God, faith or the Church.
- Here I am Lord; I come to do your will – Wondering what God may be calling you to be for life? Hear from a group of people striving to live their vocation: priest, religious, married, and someone discerning like you.
- YouCat – LeAnne Osborn: In 2011, the Church gave youth of the world a gift to guide them through questions about faith. It can deepen understanding of your relationship with God and our faith community.
- Living on a Prayer– Is prayer really that important? How do you even pray? Come and learn how prayer can open communications between you and God!
- Live like a Man (with faith) –Brian Pruitt: Saginaw area Hall of Fame football player Brian Pruitt will help you see how you can live as a man of faith in this crazy world.
- Youth Ministry 101 – Kathy Wolf McCormick of RCL Benziger Publishing: Learn how you develop a dynamic youth ministry program by applying the eight components of youth ministry.
- Serving others with Faith, Hope & Love –Sisters of Life, New York, NY
- Fr. Tony Ricard – Breakout Session
- Sarah Hart – Breakout Session
PERMISSION FORMS
MYE FAITH YOUTH RALLY: HOPE 2013
August 10, 2013
Section A: Registration Information and Statement of Consent
Name:______Date of Birth:______
Street Address:______Parish:______
City/State/ZIP:______Male ______Female______
Cell number:______Email:______
Mother’s Name:______Father’s Name:______
Parent Cell number:______
Parent email:______
Breakout choices (list session #): A)______B)______C)_
I hereby consent to participation by my child in the event described above. I understand that this event will take place away from the school/parish grounds and that my child will be under the supervision of the designated school/parish employee/volunteer on the stated date(s). I further consent to the conditions stated above on participation in this event, including the method of transportation.
In consideration of my child being allowed to participate in this field trip, I agree to indemnify and hold harmless and defend School/Parish, the Catholic Diocese of Saginaw, any and all affiliated organizations, their employees, agents, and representatives, including volunteer and other drivers, from any and all claims, including negligence, arising from or relating to my child’s participation in this field trip. This indemnification and hold harmless and defense agreement does not apply to claims for intentional misconduct.
______
(Print parent’s name) (Parent’s signature)(Date)
Section B: Media Release
(Must be completed for those under the age of 18)
I ______, hereby give permission for the personnel of the Catholic Dioceseof Saginaw to photograph, videotape and/or voice-tape my child/children (or allow area news reporters to do the same for the purposes of (please check the items you will allow):
______In-School/Parish Purposes use only______Public information for promotion of
Diocesan, School, or Parish programs (brochures,
newspapers, radio, or television)
______Catholic Diocese of Saginaw website______Parish website
Student Name (s): ______Parent Name:______
Parent/Guardian Signature:______Date:______
Section C: Medical Treatment Authorization
To Whom It May Concern:
[As a parent/guardian (for a minor child)], I hereby authorize the treatment by a qualified and licensed physician of any condition which, in the opinion of the physician, is deemed necessary and appropriate. This authority is granted only after a reasonable effort has been made to reach me/my family.
Participant’s Name:______
Relationship to you: ______Minor Child ______Self
Reason for which release is intended: MYE Faith Youth Rally: Hope 2013
Address: City:
Emergency Phone(s): ( ) ( )
Family Physician: Phone:
Physician Address: City:
List allergies, food allergies or sensitivities, medications, contacts, or other pertinent comments:
Health Insurance Data:
Company: Policy:
Group: Contract:
I further authorize the person who presents the minor to sign the Acknowledgment of Receipt of Notice Privacy Rights that may be presented by the physician or health care facility.
This authorization is completed and signed of my own free will with the sole purpose of authorizing medical treatment deemed necessary and appropriate by the treating physician.
Date:______Signed:
Participant, Parent/Guardian (for minor child)