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Youth Ministry - Laser Tag on Saturday, October 26, 2024 @ 6:00 PM

Price:

15.00

*Attendee's First Name:

*Attendee's Last Name:

*Attendee's Email Address:

*Attendee's Phone Number:

Country:

Address Line 1:

Address Line 2:

City, State Zip:

$15 per child. $25 for two siblings. $30 for three siblings and $10 more for every next sibling.

Please email youth@saintjoseph.cc for the sibling discount promo codes.

*Grade:

Parish:

*Parent Name:

*Parent Phone Number:

*Parent Email:

*EMERGENCY Contact Phone:

The following questions are part of the Permission & Release Agreement in the Meeting Instructions. Copy & Paste this link to access the waiver. https://drive.google.com/file/d/1nAefUL-rMrXoutuqy893ZcdTsQpjASVl/view:

*required* I hereby grant permission to any Parish or Archdiocesan staff member or volunteer to provide the following over-the-counter drugs (or their generic equivalent) to my Child if requested by my Child during the Activities, in accordance with dosage instructions provided on the corresponding drug's packaging. Please type out all that apply (if all apply, type ALL. If none, type NONE).

Tylenol/Acetaminophen

Imodium/Antidiarrheal

Benadryl/Diphenhydramine

Neosporin/Antibiotic Ointment

Advil/Ibuprofen

Pepto Bismol

*Check One *required*:

My child is covered by hospitalization and medical insuranceMy child is NOT covered by medical insurance. I assume responsibility for cost of medical care for my child.

*This question takes the place of printing and signing a paper waiver *required* Your response to this question refers to WAIVER: PERMISSION, ASSUMPTION OF RISK, & RELEASE AGREEMENT FOR MINOR PARTICIPANT available at the top of this page. Please read the waiver and provide consent below. (Titled "Required Waiver" above in the "Meeting Instructions" section).

I acceptI decline

Promo Code:

Registration Total: