March For Life 2018
Type of Event: Road trip to St. Paul, MN for March for Life rally.
Date January 22, 2018
Departing 9:00 am from St. Francis Xavier Education Center Returning: 3:00 pm to St. Francis Xavier Education Center
Details: Trip includes: Bus transportation to Ecumenical Prayer service at the Cathedral / March For Life at the Capitol
Bring money for lunch! Wear appropriate clothing for the weather.
Mode of Transportation: Bus
Cost of Event: $20.00
Registration deadline: January 2, 2018
Questions? Contact Group Leader
Debbie Gladitsch at 763-489-9224 or Debbie.email@example.com
Name of Participant
Name of Parent or Guardian
By checking this box I am acknowledging that I am the parent of the above named participant and acknowledge that this serves as my signature.
I grant permission for my child TO PARTICIPATE IN THE ABOVE-DESCRIBED EVENT. I warrant that my child is in good health. In consideration of my child’s participation, I agree to indemnify St. Francis Xavier Church, other participating parishes, and the Archdiocese of St. Paul & Minneapolis from any claims or law suits brought by myself, my child, or others, that arises out of any behavior by my child at the event/activity described above. I also agree to pay reasonable attorney’s fees or expenses incurred by St. Francis Xavier Church, other participating parishes, and the Archdiocese of St. Paul & Minneapolis from in defense of such a claim/suit. I agree to drop my child off at the departure location at least 15 minutes prior to departure and to provide transportation home at my expense. I agree that I am responsible for my child’s conduct and actions. The event sponsor is not responsible for any injury or damage incurred or caused by my child. I understand that my child is required to comply with the Code of Conduct provided by St. Francis Xavier Church, other participating parishes, and the Archdiocese of St. Paul & Minneapolis while participating in the event. I understand that if my child violates the Code of Conduct he/she may be required to be transported home at my expense. I also give permission for video, pictures, or other images of my child to be used for Extreme Faith Camp promotional videos, flyers or other materials related to St. Francis Xavier Church and other participating parishes youth programs.
By checking this box I am acknowledging that I have read the above statement and agree to all of the above stated considerations and conditions.
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Email - Parent
Phone Number #1 - Parent
Phone Number #2- Parent
Email - Teen
Phone Number - Teen
Code of Conduct
The following are a few rules that all participants are expected to follow while participating and representing St. Francis Xavier Church and other participating parishes at Extreme Faith Camp.
Treat all other persons with respect and not cause any intentional harm (physically, emotionally, or spiritually) to any person in any way.
Respect the property of others, including all program facilities and property.
Follow all appropriate instructions of all personnel aiding in this event, including, but not limited to, chaperones, support staff, transportation personnel and administration.
Not have in my possession any tobacco, alcohol or any controlled illegal substance
Does not participate in Bullying as defined below:
Bullying is unwanted, aggressive behavior among school aged children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time. Both kids who are bullied and who bully others may have serious, lasting problems.
In order to be considered bullying, the behavior must be aggressive and include:
• An Imbalance of Power: Kids who bully use their power—such as physical strength, access to embarrassing information, or popularity—to control or harm others. Power imbalances can change over time and in different situations, even if they involve the same people.
• Repetition: Bullying behaviors happen more than once or have the potential to happen more than once.
Bullying includes actions such as making threats, talking behind the victims back, spreading rumors, attacking someone physically or verbally, intentionally ignoring and excluding someone from a group on purpose.
I agree that if any of these terms are violated St. Francis Xavier Church and other participating parishes, will send participant home at your expense.
Teen: Checking this box I am acknowledging that I have read the above statement and agree to all of the above stated considerations and conditions.
Parent: Checking this box I am acknowledging that I have read the above statement and agree to all of the above stated considerations and conditions.
Cost: To pay please check the box below
Participant's current grade
7th grade or younger - parent will be in attendance
Do Not Fill This Out