Middle School Events Archives - Blessed Sacrament Catholic Church

Event Details

DATE

June 6, 2023

COST

$112
(includes park admission, transportation, and all-day drink wristband)

DESTINATION

Cedar Point
Sandusky, OH

TRANSPORTATION

1 motorcoach bus

SUPERVISORS

Christine Sellnow
Kathy Russell

Child's Information

Child's Name

First Last

Age

Grade

(For the 22-23 school year)

Child's Buddy's Name

First Last

Permission

As parent(s) or legal guardian(s), I give my permission for my child (listed above) to participate in this MACCY event. I understand that this event takes place away from the parish grounds and that my teen will be under supervision by the listed designated supervisors and chaperones. I further consent that as parent or legal guardian I remain fully responsible for any legal responsibility, which may result from any personal action taken by named participant. I also consent to the method of transportation being used in this event.

E-Signature(Required)

By typing your name, you are signing this Form electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Form. By typing your name using any device, means or action, you consent to the legally binding terms and conditions of this Form. You further agree that your signature on this document (hereafter referred to as your “E-Signature”) is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and Blessed Sacrament. You are also confirming that you are the parent/guardian authorized to enter into this Agreement.

Date

Medical Release

In case medical treatment is necessary and the parents or guardian cannot be reached, the following authorization is needed. I/We authorize the adult advisor in charge (Christine Sellnow) to consent to any necessary examination, anesthetic, medical diagnosis, surgery or treatment, and/or hospital care to be rendered to the above named minor, under general or special supervision and on the advice of any physician or surgeon licensed to practice medicine in the state of Michigan and/or Ohio.

Allergies

Chronic diseases or medical problems

Medications currently taking

Medicines that need to be dispensed during this activity must be given to the designated supervisor in its original container with directions and dosage.

I authorize my son/daughter to receive Acetaminophen(Required)

Yes

No

Medical Insurance Carrier(Required)

Policy/ Contract Number(Required)

Family Physcian(Required)

Physcian Phone Number(Required)

Parent Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email(Required)

Phone(Required)

Emergency Phone(Required)

E-Signature(Required)

By typing your name, you are signing this Form electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Form. By typing your name using any device, means or action, you consent to the legally binding terms and conditions of this Form. You further agree that your signature on this document (hereafter referred to as your “E-Signature”) is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and Blessed Sacrament. You are also confirming that you are the parent/guardian authorized to enter into this Agreement.

Student Agreement

I agree that I will: stay with my buddy (named above) at all times in the park, check in at 3:00 p.m.with chaperones (middle school students) and be ready to leave the park at 7:45 PM SHARP! take responsibility for my behavior and the behavior of those I am with, keep my area on the bus clean, keep bus aisles clear, and be courteous to the bus driver. I agree that I will not engage in swearing or smoking or possess alcohol, drugs or firearms, nor will I engage in public displays of affection on the bus or in the park.

Student Signature

Date

Chaperones

Three adults are needed to serve as chaperones for this trip. Adults selected as chaperones will receive a t-shirt (which needs to be worn at the park) and will go for FREE! Spots are first-come, first-served. Only one adult per family will be considered for a spot as a chaperone unless the deadline passes and additional chaperones are still needed.

Chaperones must:

Attend a chaperone meeting
Check-in a group of approximately 10 teens before we leave Midland and again before the buses leave Cedar Point. (Middle school chaperones must be available for a mid-day check-in for their middle school students at 3:00 PM.)
Maintain order on the bus
Walk the park and be visible to students
Spend at least 2 hours at the chaperone station during the day
Make sure the bus is clean before going into the park and cleaned out and belongings picked up upon return to Midland

I wish to be considered for a spot as a chaperone

Yes

Name

First Last

Email

Final Checks

I have paid my child’s trip fee.(Required)

Yes

No

I understand that I must pay online or by dropping payment off to the Faith Formation Office(Required)

A link to the online payment section will be provided after submitting the form.

Yes

I understand that my child’s seat will not be saved until the Faith Formation office has received the registration forms and payments for BOTH my child AND his/her buddy.(Required)

Yes

Name

This field is for validation purposes and should be left unchanged.

Faith & Science

Faith and Science Event at the Bay City Planetarium // June 14

Event Details

Child's Information

Permission

Medical Release

Student Agreement

Chaperones

Final Checks

Faith and Science Event at the Bay City Planetarium // June 14

Midland Area Catholic Churches Youth Ministry

MACCYM Cedar Point Trip Registration Form

Event Details

Child's Information

Permission

Medical Release

Student Agreement

Chaperones

Final Checks