EDGE Registration: 2019-2020
Please complete this form and click "submit" (no need to print).

Cost: $125. Scholarships are available.
Pay ONLINE at this link: https://tinyurl.com/y72fvwua or by check ($125 per youth made out to "St. Therese of Carmel" or "STOC" and write your child's name in the memo line) to the Parish Office or place in Sunday Collection basket in an envelope marked EDGE - Harrison Trubitt.


Thank you! We are excited for another great year of EDGE!
Email address *
Student First Name *
Your answer
Student Last Name *
Your answer
Gender
Student Date of Birth *
MM
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DD
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YYYY
School *
Your answer
Grade *
Student T-Shirt Size (Adult) *
Is this your child's first year in EDGE? *
Has your child been baptized in the Catholic Church? *
Does your child need to receive any sacraments this year? (Check all that apply) *
Required
Is your family registered parishioners at St. Thérèse of Carmel? *
Parish ID #?
Your answer
Family Name (if different than child's)
Your answer
Mother's Full Name *
Your answer
Mother's Cell Phone *
Your answer
Mother's Email Address *
Your answer
Father's Full Name *
Your answer
Father's Cell Phone *
Your answer
Father's Email Address *
Your answer
Student's Cell Phone
Your answer
Student's Email Address
Your answer
Describe any allergy (including food allergies), chronic illness, or other conditions *
Your answer
Is there anything else we need to know about your student?
Your answer
Emergency Contact: Name/Relationship to Child *
Your answer
Emergency Contact: Phone Number *
Your answer
I would like to donate/"sponsor" a fellow middle school EDGE student *
Optional: If you wish, please list one or two small group member requests if that would make your child more comfortable!
Your answer
Liability Release - By checking the box below, you are "signing" this document.
I grant permission for my child to participate in EDGE. I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. If I give approval over the phone, I hereby grant permission for the parish, through its officers, to give nonprescription medication (such as aspirin, throat lozenges etc.) to my child, if deemed advisable. If taking medication at present, my child will bring all such medications necessary and release them to the adult representative in charge for distribution to my child. Such medications will be well labeled with names of medications, concise directions for seeing that the child takes such medications, including dosage and frequency of dosage. In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. As parent, or legal guardian, I remain legally responsible for any personal actions taken by my child. I agree to hold harmless and defend St. Therese of Carmel, its officers, directors and agents, Diocese of San Diego, and representatives associated with EDGE with respect to any and all actions, claims or demands that may be made or brought against the above named parties associated with the event, arising from or in connection with my child’s attending the event or in connection with any illness, injury or cost of medical treatment in connection therewith. I agree to compensate the parish, its officers, directors and agents, and the Diocese of San Diego, or representatives associated with the event for reasonable attorney’s fees and expenses arising in connection therewith.
By checking the box below, you are "signing" this document. *
A copy of your responses will be emailed to the address you provided.
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