St. Paul's Children and Youth Information Form

Help us better serve our children and youth by providing us with necessary contact and personal information.

Child or Youth Information
Child or Youth's Name Child or Youth's Name First Last
Date of Birth Date of Birth / MM / DD YYYY
Grade in School
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home/Cell Phone Home/Cell Phone - ### - ### ####
Email (if applicable)
First Parent or Contact Person Information
First Parent or Contact Person's Name First Parent or Contact Person's Name First Last
Relationship to Child
Contact Phone Number Contact Phone Number - ### - ### ####
Email
First Parent or Contact Person: Certified in Safeguarding God's Children Training

First Parent or Contact Person: Certified in Safeguarding God's Children Training Yes, I have been certified within the last 3 years. No, I would like to be certified. No, I am not interested in being certified at this time. I am not sure if I am certified or not.
As a parent/guardian, I am interested and available to support the children and youth ministries by:

As a parent/guardian, I am interested and available to support the children and youth ministries by: Providing Transportation Providing Snacks Helping out with Sunday School Helping out at Youth Group Gatherings Planning Events and Trips Fundraising Being an Extra Adult at a Gathering or Event to Ensure Safety and Fun Attending Diocesan Youth Retreats I am not able to help at this time. Other Other
Second Parent or Contact Person Information
Second Parent or Contact Person's Name Second Parent or Contact Person's Name First Last
Relationship to Child
Contact Phone Number Contact Phone Number - ### - ### ####
Email
Second Parent or Contact Person: Certified in Safeguarding God's Children Training

Second Parent or Contact Person: Certified in Safeguarding God's Children Training Yes, I have been certified within the last 3 years. No, I would like to be certified. No, I am not interested in being certified at this time. I am not sure if I am certified or not.
As a parent/guardian, I am interested and available to support the children and youth ministries by:

As a parent/guardian, I am interested and available to support the children and youth ministries by: Providing Transportation Providing Snacks Helping out with Sunday School Helping out at Youth Group Gatherings Planning Events and Trips Fundraising Being an Extra Adult at a Gathering or Event to Ensure Safety and Fun Attending Diocesan Youth Retreats I am not able to help at this time. Other Other
Additional Important Information
Best Means of Communication

Best Means of Communication Parent's Cell Phone Child's Cell Phone Home Phone Parent's Email Child's Email Other Other
Special Concerns:
Are there any special needs or learning styles that will help us know your child better and guide us in our interactions with your child?
Are there any medical conditions we should be aware of?
Media Permission:
Throughout the year, we may take pictures to put on the St. Paul's website or social media pages. We respect your child's privacy. Please check the appropriate box below to let us know whether or not you give permission for your child's picture to appear on the website and/or social media pages.

Media Permission:
Throughout the year, we may take pictures to put on the St. Paul's website or social media pages. We respect your child's privacy. Please check the appropriate box below to let us know whether or not you give permission for your child's picture to appear on the website and/or social media pages. I give permission for my child's picture to appear on the St. Paul's website and/or social media pages. I do NOT give permission for my child's picture to appear on the St. Paul's website and/or social media pages.

St. Paul's Children and Youth Information Form

St. Paul's Children and Youth Information Form

Child or Youth Information

First Parent or Contact Person Information

Second Parent or Contact Person Information

Additional Important Information