Mission Days Emmaus Teens July 10-12, 2024
Registration form for incoming 8 -12 graders for our mini mission service experience beginning the evening of Wednesday, July 10-12


Details will be sent after registration.  Activities will include:

*prayer and adoration,
*service at local agencies (soup kitchen, food pantries, etc) and
*activities and guest speakers on the themes of Catholic Social Teaching

Open to youth entering 8th grade to new high school graduates..

Tentative Schedule:
Wed.   6pm-8pm gather at St Agnes for activities and prayer. Get service assignments.
Thur.   8am-6pm start day with Mass, go to service sites BRING LUNCH, snacks provided, Dinner provided.
Friday, July 12-8am-2pm  serve in morning end with lunch and prayer by 2pm

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Participant's Name *
Parent Cell Phone *
Parent Name *
Allergies, food sensitivities, medial concerns or learning concerns, medications or other information that is necessary for us to care for your young person *
Emergency name and contact. Please provide two *
Photo and Video Permission:  I give permission for my child to be photographed or video recorded and for these images to be used on the parish or school website and social media. (we do not add names to any photos when we post) *
Medical Release and Permission to Participate: I hereby give permission for my child/ward above named, to participate in the above event. I hereby release and indemnify St. Agnes Parish the Diocese of Springfield, its staff and volunteers, all participating parishes and partnering organizations and the Catholic Bishop of Springfield from any and all liability arising from claims of any kind or nature whatsoever from my child's participation in this program. I further agree that my child/ward will comply with all adult direction, behave in a manner becoming a Christian and should he/she be dismissed from the program, I will pay all expenses.  In the event of an emergency, I hereby give permission to transport my child to a qualified health care facility for emergency medical or surgical treatment and authorize the release of medical records to qualified physicians for the treatment.  I understand that I will be promptly notified in the event any illness or accident requires professional medical care and prior to any surgery except when delay in such communication would endanger life.  In the event that I cannot be reached, I hereby give permission to the physicians selected by the leaders of the event my child is participating in to hospitalize, secure proper treatment for, and to order tests, therapies, or surgery if deemed necessary for my child.  I also verify that my child shows no symptoms of Covid-19 for 5 days before and during the event. *
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