YDisciple Student Registration Form
YDisciple is a small group faith sharing opportunity, offered to the youth of St. Gerald Parish. The day, time, location and frequency of the Small Group will be determined by each YDisciple Group. YDisciple Groups will be invited to monthly GLOW - Youth Ministry Large Group events. If you are currently in a YDisciple Group or would like to get involved, please complete this Commitment Form. We look forward to sharing our time with you, soon!
Participant Information
First & Last Name *
Your answer
Address *
Your answer
Student Cell Number
Your answer
Student Email Address *
Your answer
Student Current Grade *
Your answer
Parent Names *
Your answer
Mom Cell Number
Your answer
Dad Cell Number
Your answer
Parent Email Address *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Family Health Information
Does your child have any health concerns or special needs we need to be aware of to ensure a great experience? (please describe) *
Your answer
Does your child take any medications or have any allergies? (please list, if applicable) *
Your answer
Permission to Participate
I grant permission for my child(ren) to participate in this youth ministry event that is located on the parish/school site. This activity will take place under the guidance and direction of Archdiocesan parish/campus youth ministers and/or volunteers from parishes/schools.
Parent Signature *
Your answer
Consent to Contact Physician In Case of Emergency
In the event that I cannot be reached to make arrangements, I hereby give my consent to St. Gerald parish to transport my child to a clinic or hospital and seek treatment.
Parent Signature *
Your answer
Permission to Publish Pictures
I hereby give St. Gerald Parish permission to publish pictures of my child/children on the parish website or in parish publications.
Parent Signature *
Your answer
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