Mini Mission "trip" for Teens: Engage Race July 8-9-10, 2021 St. Agnes
Registration form for 6-12 graders for our mini mission service experience beginning in the evening of Thursday July 8 and ending Saturday morning July 10.

DEADLINE TO REGISGTER IS JULY 1

Participants will go home each night and Covid precautions will be taken during the event.

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 topic of systemic racism and Catholic Social Teaching

Participants will be put in small groups by age and activities may differ for High School and Middle School youth.

Open to youth entering 7th grade to new high school graduates..

Tentative Schedule:
Thursday 7/8-6-8pm gather at St Agnes for activities and prayer on systemic racism
Friday 7/9 8am-6pm start day with Mass, go to service sites: Camp Compass, Habitat, Ronald McDonald House etc) Bring lunch, snacks provided
Saturday 8-12-gather at St. Agnes go to serve at Martin DePorres Center. Return to St. Ag for closing and lunch
Participant's Name
Address
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
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. *
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