St. Joseph - Odenton Middle School Youth Ministry Who We Are St. Catherine of Siena said "When you are who you are called to be you will set the world ablaze!" Blaze, our Middle School Youth Ministry, offers opportunities throughout the year for youth in Grades 6-8 to meet other middle schoolers, get involved in outreach, and have fun in a safe and spiritually enriched environment.

What We Do The goal of the Blaze ministry is to offer one social event and one service event each month. A mini-camp of service is offered during the summer. Planned events can be found on www.stjosephodenton.org under Middle School Youth Ministry (Blaze). Please be sure to check the bulletin, website and emails for the latest news and events.

Enrollment We ask that all teens participating in Blaze register using the attached form. Registration helps us keep current contact and basic emergency information on file. This information helps the Blaze team communicate upcoming events and the latest information with the youth and their parents as well as anticipate the number of youth who will be participating during the year. For any off-site activity, parents will also need to complete a Permission Form as required by the Archdiocese of Baltimore in order for their teen to participate. Permission forms and due dates will be made available as the off-site activities are announced.

Parent Chaperones & Drivers All parents wishing to help out with Blaze, including chaperoning events or helping drive teens to an event, must comply with the Archdiocese policies for Child Protection. More information about the policies and the required forms can be found on the parish website (www.stjosephodenton.org) under Child Protection. Please indicate on the registration form how you can help out!

For More Information If you have any questions about having your child participate in Blaze, please do not hesitate to contact Michele Dougherty, Coordinator of Youth & Young Adult Ministry at [email protected] or call the parish at 410-674-9238.

Middle School Youth Ministry Registration Form 2016-2017 PARENT INFORMATION: Family Name________________________ Phone__________________ E-mail________________________ Address________________________________________City/Zip ___________________________________ Father’s Name_____________________________ Mother’s Name__________________________________ Father’s Cell # _____________________________ Mother’s Cell # ________________________________ Child Resides With:

( ) Both Parents

( ) Father ( ) Mother ( ) Other ________________________

In the case of separate households, let us know if a second mailing or email address is necessary (attach).

In order to provide a safe and enjoyable experience for all, we rely on the help of parents to help chaperone events and provide transportation. We require both male and female chaperones. Please indicate below if you are able on occasion to assist. All chaperones must comply with the Archdiocese’s Policy of the Protection of Children and Youth (STV-Shield the Vulnerable). STV requirements and forms can be downloaded at www.stjosephodenton.org under Child Protection. Can Dad: Help chaperone events? Yes No Help drive for events? Yes No Is Dad: STV Certified? Yes No Had a Driver’s Check? Yes No

Can Mom: Help chaperone events? Yes No Help drive for events? Yes No Is Mom: STV Certified? Yes No Had a Driver’s Check? Yes No

YOUTH #1: Name ____________________________________ Nickname ___________________ Grade __________ Cell Phone # ______________________________ Email _______________________________________ School Attending _______________________________________________________________________ Please list any regular medications your child takes or any medical condition or allergies your child has that we should be aware of: _______________________________________________________________________ YOUTH #2: Name ____________________________________ Nickname ___________________ Grade __________ Cell Phone # ______________________________ Email _______________________________________ School Attending _______________________________________________________________________ Please list any regular medications your child takes or any medical condition or allergies your child has that we should be aware of: _______________________________________________________________________

*** Complete and Sign the back of this form where indicated. ***

EMERGENCY CONTACT INFORMATION: Should an emergency arise and the parents cannot be reached, one of the following people may be contacted: 1______________________________________________________________________________________ Name Phone Relationship to Family 2______________________________________________________________________________________ Name Phone Relationship to Family By signing below, the parent grants permission to any staff, chaperone or adult team member present to seek medical aid from a licensed physician, hospital, or medical clinic for their child in case of an emergency and the parents cannot be reached. Check one of the following: I am covered by hospitalization and medical insurance under policy #______________________ issued by ___________________________________ . I do not have medical coverage and assume responsibility for the cost of hospitalization and medical care for my son/daughter. Parent/Guardian Signature___________________________________________ Date: _______________

RELEASE: Parents/guardians of participants are advised that photographs or video of participants may be taken at events for archival and communication purposes. These images may be used on the web page, publications, or other public displays such as bulletin boards. (Participants would not be identified by name, however, without specific written consent.) Parents acknowledge that as a participant their child may be included in such photos or videos. Parents/guardians who do not wish their child to be individually photographed or filmed should submit written notification to the Youth Ministry Office. Please note that the parish has no control over the use of photographs or film taken by media that may be covering a particular event in which your child participates. Parent/Guardian Signature___________________________________________ Date: _______________

FINANCIAL SUPPORT: There is no fee to join Blaze. Some activities may require a cost to participate (for example, snow tubing). In such instances, costs will be communicated to parents as soon as known. Costs for supplies for outreach activities are generally raised by the teens through fundraising efforts or donated. Other general overhead costs such as supplies and hospitality are provided on a donated basis or covered by the parish as the budget allows. If you would like to make a general donation (any amount) to financially support the BLAZE ministry, please include a check made payable to “St. Joseph Catholic Church” and the amount will be recorded in your annual parish offering total. No child is denied participation for financial reasons in general on-site youth group gatherings or service projects. A financial donation is not required but is greatly appreciated! Return this form to: St. Joseph Catholic Church Attn: Michele Dougherty, Youth Ministry Office 1283 Odenton Rd. Odenton, MD 21113

Office Use Only Date Received ___________ Check # _________________ Amount _________________ Date ____________________