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Red's Game Online Registration/
Permission Form

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Teen Permission Slip Copy

Archdiocese Permission Slip for H.S. Flock going to Cincinnati Reds Game on July 10, 2022 - to retain for your records. Click here to print►
Staff Contact
- Grace Curtis
  
  Coordinator of Youth Ministry
  
  513-489-8815 x737
  grace.curtisgood-shepherd.org

H.S. Flock Youth Ministry Permission Form
Sunday, July 10, 2022
The maximum number of form submissions has been reached. This form is currently not available.
- This is the online H.S. Flock Permission Form is for teens to attend the H.S. Flock Reds Game on Sunday, July 10, 2022 from 12:30-5 p.m.
  
  Details:
  
  Activity: Cincinnati Reds Game
  
  Location: Great American Ball Park, 100 Joe Nuxhall Way, Cincinnati, OH 45202
  
  Emergency No.: 513-497-5834
  
  Cost: FREE
  
  Starting Date and Time: 07/10/2022 at 12:30 p.m.
  
  Meeting Place: Good Shepherd
  
  Ending Date and Time: 07/10/2022 at 5:00 p.m.
  
  Activities Involved: Watching a Cincinnati Reds baseball game
  
  Type of Transportation: Carpooling provided by SafeParish (child protection program) trained adults
  
  Group Leader: Grace Curtis, Good Shepherd's Coordinator of Youth Ministry
  
  Each participate should have a form in order to attend. Thank you!
- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Name Please enter valid data.
- Mother's Name 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 Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Home Phone Number Maximum 20 characters Please enter a phone number.
- Dad's Cell Phone Number Maximum 20 characters Please enter a phone number.
- Mom's Cell Phone Number Maximum 20 characters Please enter a phone number.
- Primary Email REQUIRED Please fill out this field. Please enter an email address.
- Are you a registered member of Good Shepherd? REQUIRED Yes No Please fill out this field.
- How many high schoolers would you like to register for our H.S. Flock Reds Game on Sunday, July 10, 2022? REQUIRED Please fill out this field.
  
  Name of High Schooler 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.
  
  Grade Level (as of fall of 2021) REQUIRED Please fill out this field. Please enter an integer (number).
  
  School District REQUIRED Please fill out this field. Please enter valid data.
  
  Sex
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Do you need transportation to the Reds Game? REQUIRED Please fill out this field.
  
  Please list allergies (e.g. food, drugs, anesthetics). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list medications taken regularly. If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list any conditions/impairments (e.g. epilepsy, diabetes, asthma). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Name of High Schooler 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.
  
  Grade Level (as of fall of 2021) REQUIRED Please fill out this field. Please enter an integer (number).
  
  School District REQUIRED Please fill out this field. Please enter valid data.
  
  Sex
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Please list allergies (e.g. food, drugs, anesthetics). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Do you need transportation to the Reds Game? REQUIRED Please fill out this field.
  
  Please list medications taken regularly. If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list any conditions/impairments (e.g. epilepsy, diabetes, asthma). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Name of High Schooler 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.
  
  Grade Level (as of fall of 2021) REQUIRED Please fill out this field. Please enter an integer (number).
  
  School District REQUIRED Please fill out this field. Please enter valid data.
  
  Sex
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Please list allergies (e.g. food, drugs, anesthetics). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list medications taken regularly. If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Do you need transportation to the Reds Game? REQUIRED Please fill out this field.
  
  Please list any conditions/impairments (e.g. epilepsy, diabetes, asthma). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Name of High Schooler 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.
  
  Grade Level (as of fall of 2021) REQUIRED Please fill out this field. Please enter an integer (number).
  
  School District REQUIRED Please fill out this field. Please enter valid data.
  
  Sex
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Please list allergies (e.g. food, drugs, anesthetics). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list medications taken regularly. If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list any conditions/impairments (e.g. epilepsy, diabetes, asthma). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Do you need transportation to the Reds Game? REQUIRED Please fill out this field.
- FAMILY DOCTOR
- What is the name of your family doctor? REQUIRED Please fill out this field. Please enter valid data.
- Phone number for your family doctor. REQUIRED Please fill out this field. Please enter valid data.
- #1 EMERGENCY CONTACT
- List Emergency Contact (other than parents).
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship Please enter valid data.
- Phone Number Maximum 20 characters Please enter a phone number.
- #2 EMERGENCY CONTACT
- List Emergency Contact (other than parents).
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship Please enter valid data.
- Phone Number Maximum 20 characters Please enter a phone number.
- ARCHDIOCESE OF CINCINNATI YOUTH
  PERMISSION FORM FOR H.S. FLOCK REDS GAME
  Sunday, July 10, 2022 from 12:30-5 p.m.
  
  Please download, read and retain the Archdiocese of Cincinnati Permission, Release and Authorization to Seek Medical Treatment form ►
- I have read and agree to the Archdiocese of Cincinnati Permission, Release and Authorization to Seek Medical Treatment form that has been provided in the block above. REQUIRED Yes No Please fill out this field.
- PHOTO PERMISSION
  I understand that Good Shepherd’s Faith Formation staff may take photos and videos during activities for the purpose of promoting the programs via our website, Sunday bulletin, parish social media page (for example, Facebook, Twitter, Instagram), or news releases to local or diocesan papers. I give my permission for pictures that are taken of my family, adults and children, to be used for this purpose.
- I have read and agree to the Photo Permission statement listed above. REQUIRED Yes No Please fill out this field.
- Please be aware that we will continue to follow the guidelines of the Archdiocese of Cincinnati regarding social distancing and other precautions due to the COVID-19 pandemic. We appreciate your patience and flexibility in the event changes in the pandemic leads to restructuring of program dates and classroom capacities.
- I have read and understand that we are following all Archdiocesan Guidelines related to the pandemic, and if changes occur with the pandemic we will adjust accordingly. REQUIRED Yes, I have read and agree to the statement above regarding the pandemic. Please fill out this field.
- By clicking on the "I Agree" box, it will serve as your digital signature for this submission.
  I Agree Please select this field.
- If you would like to share any additional information, please do so in the box below.
- Name of Custodial Parent/Legal Guardian REQUIRED Please fill out this field. Please enter valid data.
- Please type your initials below. REQUIRED Please fill out this field. Please enter valid data.
- Today's Date REQUIRED Please fill out this field. Please enter a date.
Submit

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Red's Game Online Registration/Permission Form

Red's Game Online Registration/
Permission Form