High School Harbor Cruise
High School Youth Ministry Harbor Cruise
High School Grades 9 to 12
Monday, July 30th
$25.00
We will meet at Saint Ann's at 6:45p.  
The cruise leaves at 8p and returns at 11p.  
We should be back to Saint Ann's by 11:30p

Please fill out registration form and return to website to pay using paypal or drop payment off at the rectory (if office is closed you may place in mail slot on front door).

Thank You
Paula
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Name of Child #1
Date Of Birth for Child #1
Name of Child # 2
Date Of Birth for Child #2
Name of Child # 3
Date Of Birth for Child #3
Name of Child #4
Date Of Birth for Child #4
Are you interested in Chaperoning?
Clear selection
If yes, name of person Chaperoning.
Parent name
Home phone
Cell phone
Street address
Zip code
Email Address
Emergency contact name and phone number
Allergies?
Any medical condition that we should be made aware of?
Medications
Comments, Questions or Concerns
Parental release (please read and initial below)
In initialing this form I hereby certify that the above information is correct and give permission for my child to participate in this activity. I give permission for the release of medical records to the attending physician in case of injury or illness. In case of medical emergency, I understand that every effort will be made to contact the parent(s)/guardian of the child. In the event that I cannot be reached. I hereby give permission to the physician attending my child to hospitalize and secure proper, necessary treatment for my son/daughter named herein. I hereby agree the Saint Ann Parish, Dorchester, the Archdiocese of Boston, any of their employees or agents assumes no liability for claims that may arise out of this activity.
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