Youth Ministry Registration


There are two payment options for registration:

1. Pay in full today

2. A 5 month Payment Plan ($18/month for Life Teen, $13/month for Edge)


Upon submission of this registration form, an automatic email will be sent containing your discount code for the upcoming year. 

Please note that these codes are not intended to be shared and should be saved for reference throughout the year.



Registration Information

Youth 1 Information

Name*
Which Program *
Gender*
Date of Birth*
Is your son/daughter Catholic?
All youth are welcome! This information just helps us prepare understand the demographic of ministry.
Sacraments Received
Select all the apply

Youth 2 Information

Name*
Which Program *
Gender*
Date of Birth*
Is your son/daughter Catholic?
All youth are welcome! This information just helps us prepare understand the demographic of ministry.
Sacraments Received
Select all that apply

Youth 3 Information

Name*
Which Program *
Gender*
Date of Birth*
Is your son/daughter Catholic?
All youth are welcome! This information just helps us prepare understand the demographic of ministry.
Sacraments Received
Select all that apply

Youth 4 Information

Name*
Which Program *
Gender*
Date of Birth*
Is your son/daughter Catholic?
All youth are welcome! This information just helps us prepare understand the demographic of ministry.
Sacraments Received
Select all that apply

Family Information

Address*
Parent/Guardian Name #1*
Relationship to Youth*
Parent/Guardian Name #2
Relationship to Youth
Is your family currently registered at St. Timothy?*

Emergency Contact (Other than Listed Above)

Emergency Contact Name*

Medication Procedure

We understand that some teens may at times require medication during overnight/out of town youth ministry events. While we desire to make every effort to assist in the well being of every teen, please understand that the youth leader and core team members are not explicitly trained in this field. We rely on good communication with you, the parents, in order to care for your teen.

  • All prescription medication must be turned in during the check-in process at the time of departure for trips with an accompanying “Medication Check-In” form which requires a parent signature. This form will be available prior to the event and at the check in process. We do not accept non-prescription medication.
  • High School teens must be able to administer their own medication and should be able to request their medication from the designated adult leader. Junior High teens are encouraged to be able to administer his/her own medication, but are to be assisted by an adult leader who will provide medication according to the Medication Check-In form.
  • High School teens who are not able to dispense their own medication, or who require an adult aid in their daily activities, will be required to bring an adult aid (21 years or older) to the event. An adult aid must also complete an event registration and payment.
  • Our first aid kit includes general over the counter medication, such as pain killers and Benadryl. Permission to administer/receive these medications is requested as part of our standard registration form.
I have read and agree to abide by the above medication procedure.*

Liability Waiver

I request that St. Timothy Catholic Church allow me and my children to attend LIFE TEEN and/or EDGE for the 2023-24 school year. In consideration for my participation, on behalf of myself, my child (ren), and our heirs, assigns, executors and personal representatives, I hereby release, absolve, indemnify and agree to hold harmless St. Timothy Roman Catholic Parish Mesa, the Roman Catholic Church of the Diocese of Phoenix, and any and all of their officers, directors, agents, employees, representatives, volunteers, or sponsors from any and all liability for any and all injury that may arise out of participation in this activity. I also authorize the supervisor of LIFE TEEN and/or EDGE or his/her designee to provide first aid or similar care in non-emergency situations, and to seek emergency medical assistance when they deem it necessary, for which I will be financially responsible. I give permission to have photos taken of my child for the purpose of parish use.

Parent/Guardian Name*
Use your mouse or finger to draw your signature above
Date*

Safe Environment

The Diocese of Phoenix mandates that Safe Environment training is given to every child in Catholic schools and religious education sessions. Age appropriate Safe Environment training will be integrated into EDGE and Life Teen sessions and offered to the child(ren) attending St. Timothy EDGE and Life Teen programs in January, 2024. For specific dates, or to receive a copy of the curriculum, please contact the coordinator. If the child(ren) does not attend the training, the parent is responsible for presenting the material to the child(ren). I grant permission for my child(ren) to receive Safe Environment education training. *
The Diocese of Phoenix acknowledges the value of technology in ministry and communication. St. Timothy Edge and Life Teen utilize Flocknote, Instagram, Slack, Zoom, and St. Timothy parish emails with ministry members, including minors. All communication follows Diocesan Policies that ensure transparency and shared access. Permission to communicate through technology platforms does not include use of private/personal accounts or numbers between adult ministry leaders and minors. All communication means are operated through ministry accounts and never personal/individual/private accounts. Permission to communicate does not require any minor to participate in technological communication at any time (eg. a parent may give permission but may choose not to provide youth email/phone information).*
Please feel free to contact Meagan Martinez, Director of Youth Ministry, for additional clarification on communication policies with minors.
Name of Parent/Guardian providing permission*
Use your mouse or finger to draw your signature above
Date/Time*

Payment

Do you have a ministry credit to apply?
Would you like to include a donation to support the needs of the ministry not covered by registration costs, including scholarships, core formation, special events, etc.?*
$
$
How will you pay today?*
$
$
Date the first payment will be charged: