HOME
ABOUT
WELCOME!
CONTACT US
CALENDAR
HISTORY AND PATRON SAINT
OUR PILGRIM PRIEST
PHOTOS AND VIDEOS
RESOURCES AND LINKS
PARISH COUNCIL
FINANCE COMMITTEE
PARISH BULLETIN
SAFE ENVIRONMENT
SERVE
BEREAVEMENT AND CONSOLATION
BLESSINGS BOX
FOOD AND SHELTER
HELP AND HOSPITALITY TEAM
KAIROS PRISON MINISTRY
LITURGICAL MINISTRIES
MARTHA AND MARY GUILD
MCKOWN VILLAGE #8
MINISTRY TO ENGAGED COUPLES
POOR BOX
PRAYER LINE
ST. VINCENT DE PAUL SOCIETY
COMMUNITY
OUR CAMPUS
Louise Kay Education Center
Ransom's Garden
Shrine to Our Lady
COFFEE AND PASTRY VOLUNTEERS
DISCERNMENT GROUP
GRIEF SUPPORT GROUP
HOLY ROSARY PRAYER GROUP
KNIGHTS OF COLUMBUS
PRIMETIMERS
TRUE FAMILY LECTURE
WOMEN'S CIRCLE
DONATE
CAMPUS MINISTRY
CHILDREN'S MINISTRY
SACRAMENTS
TOTUS TUUS SUMMER PROGRAM
FORMS
Consent Form (REQUIRED)
CHILI BINGO
CIRCLE OF GRACE
MUSIC MINISTRY
SUNG VESPERS
LUNCHTIME RECITALS
COMPLINE
CONCERTS
SKINNER PIPE ORGAN
ANTHEM SCHEDULE
FUNDRAISERS
|||
ST. THOMAS MORE
UNIVERSITY PARISH
and STUDENT CENTER
Facebook
Instagram
YouTube
Search
Search
HOME
ABOUT
WELCOME!
CONTACT US
CALENDAR
HISTORY AND PATRON SAINT
OUR PILGRIM PRIEST
PHOTOS AND VIDEOS
RESOURCES AND LINKS
PARISH COUNCIL
FINANCE COMMITTEE
PARISH BULLETIN
SAFE ENVIRONMENT
SERVE
BEREAVEMENT AND CONSOLATION
BLESSINGS BOX
FOOD AND SHELTER
HELP AND HOSPITALITY TEAM
KAIROS PRISON MINISTRY
LITURGICAL MINISTRIES
MARTHA AND MARY GUILD
MCKOWN VILLAGE #8
MINISTRY TO ENGAGED COUPLES
POOR BOX
PRAYER LINE
ST. VINCENT DE PAUL SOCIETY
COMMUNITY
OUR CAMPUS
COFFEE AND PASTRY VOLUNTEERS
DISCERNMENT GROUP
GRIEF SUPPORT GROUP
HOLY ROSARY PRAYER GROUP
KNIGHTS OF COLUMBUS
PRIMETIMERS
TRUE FAMILY LECTURE
WOMEN'S CIRCLE
DONATE
CAMPUS MINISTRY
CHILDREN'S MINISTRY
SACRAMENTS
TOTUS TUUS SUMMER PROGRAM
FORMS
CHILI BINGO
CIRCLE OF GRACE
MUSIC MINISTRY
SUNG VESPERS
LUNCHTIME RECITALS
COMPLINE
CONCERTS
SKINNER PIPE ORGAN
ANTHEM SCHEDULE
FUNDRAISERS
Consent Form (REQUIRED)
CHILDREN'S MINISTRY
SACRAMENTS
TOTUS TUUS SUMMER PROGRAM
FORMS
Consent Form (REQUIRED)
CHILI BINGO
CIRCLE OF GRACE
The maximum number of form submissions has been reached. This form is currently not available.
REGISTRATION CONSENT AND WAIVER FORM FOR YOUTH ACTIVITIES
This Form must be completed and executed for participation in the Youth Activities as a part of registration.
Number of Program Participants (Children)
REQUIRED
Please fill out this field.
Child 1
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 2
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 3
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 4
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 5
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 6
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 7
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 8
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 9
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Child 10
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
Girl
Boy
Please fill out this field.
Participant's Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Participant Resides With:
REQUIRED
Mother
Father
Guardian(s)
Please fill out this field.
Is Participant taking any medications OR have any medical conditions? (e.g., diabetes, epilepsy, heart conditions, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Does Participant have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)
YES
NO
If answered "YES," please explain:
Please enter valid data.
Does Participant have any disabilities or physical or developmental limitations?
REQUIRED
YES
NO
Please fill out this field.
If answered "YES," please explain:
Please enter valid data.
Date of Last Tetanus Immunization
Please enter a date.
Custodial Parent/Legal Guardian Information
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Email
REQUIRED
Please fill out this field.
Please enter an email address.
Primary Phone Number
REQUIRED
Please fill out this field.
Please enter a phone number.
Type of Phone
REQUIRED
(Select One)
Cell
Work
Home
Please fill out this field.
Secondary Phone Number
Please enter a phone number.
Type of Phone
None
Cell
Work
Home
Primary Doctor
First Name
Please enter valid data.
Last Name
Please enter valid data.
Phone Number
Please enter a phone number.
Health Plan Carrier
Insurance Name
Please enter valid data.
Policy #
Please enter valid data.
Group #
Please enter valid data.
Name of Primary Insured
Please enter valid data.
PARTICIPATION PERMISSION: I, the undersigned, am custodial parent/legal guardian of Participant and request that he/she be to allowed participate in the Youth programs, events and activities to be held at St. Thomas More Parish and St. Joseph Catholic Church during the 2019/2020 school/parish year (the “Youth Activities”). I understand that the Youth Activities consist of weekly sessions and related activities which may be held from time to-time.
I Agree
Please select this field.
LOST OR STOLEN ITEMS: I hereby understand and agree that neither the Diocese of Tulsa/Archdiocese of Oklahoma City, St. Thomas More University Parish, St. Joseph Catholic Church, nor any of their respective employees, directors, officers, agents, representatives and/or volunteers shall be held liable for any of my or my child’s personal property lost or stolen during participation in the Youth Activities.
I Agree
Please select this field.
As a rule, medication will not be administered by Youth Program staff. The exception is a youth program or activity that includes an extended day or overnight activity. If medication is required a separate Consent and Waiver Medication Form must be completed prior to the activity.
CONSENT TO TREATMENT OF PARTICIPANT: I am the custodial parent or legal guardian of Participant. I hereby warrant that, to the best of my knowledge, Participant is in good health and physically able to participate in the Youth Activities, and I assume all responsibility for the health, physical condition, and ability of Participant to so participate. In the event of circumstances that indicate that Participant is in need of immediate medical care, I authorize and give permission for Participant to be transported to a hospital/clinic/medical facility for evaluation and emergency medical or surgical treatment, including any necessary X-ray examination. I authorize any licensed physician or medical center to treat Participant. I accept full responsibility for any medical or hospital bills associated with the care of Participant.
I Agree
Please select this field.
LIABILITY WAIVER: In consideration of the arrangement set forth herein, I do on behalf of myself, Participant and our respective heirs, successors, assigns and next of kin, release, waive, hold harmless, defend and covenant NOT TO SUE, St. Thomas More University Parish, St. Joseph Catholic Church, the Bishop of the Diocese of Tulsa/Archdiocese of Oklahoma City, and/or the Diocese of Tulsa/Archdiocese of Oklahoma City, and each of their respective departments, directors, administrators, teachers, officers, agents, representatives, volunteers and employees from any and all actions, claims, demands or liabilities, including without limitation, those for personal injuries or property damage, that I and/or Participant may suffer due to illness or injury suffered by Participant as a result of, or in connection with, participation in the Youth Activities, including the administration of authorized medications, medical treatment and any consequences that may arise as the result of said treatment, including without limitation, housing, meals and collateral entertainment to the fullest extent permitted by law. I certify to you that the information contained herein is true and correct to the best of my knowledge and that I fully understand the terms and legal consequences of my execution of this REGISTRATION CONSENT AND WAIVER FORM FOR YOUTH ACTIVITIES.
I Agree
Please select this field.
By typing your full, legal name in the box below, you are indicating that you are the custodial parent/legal guardian of the participant(s), that all of the above information is complete and accurate, that you understand and accept all above statements, and that you are allowing St. Thomas More University Parish, St. Joseph Parish, Totus Tuus, the Archdiocese of Oklahoma City, and the Diocese of Tulsa to accept your typed name as your digital signature which will be considered equivalent to your handwritten signature.
Please, type your full legal name to indicate your digital signature and completion of this document.
REQUIRED
Please fill out this field.
Please enter valid data.
ALL PARTICIPANTS FOURTEEN YEARS OF AGE AND OLDER must read and agree to the following statement: I acknowledge that I agree to conduct myself in a manner consistent with the policies of the St. Thomas More Parish and that failure to do so may result in my being required to leave the Youth Activity, and not being allowed to participate in future programs and activities, at the discretion of the Parish/School.
Please, type your full legal name to indicate your digital signature and agreement with the above statement.
Please enter valid data.
Submit