Crossroads Registration

Permission/Release Form Registration Information
Parental Permission / Release Form

I, give my child, , permission to participate in the Crossroads Youth Ministry program at St. John of the Cross Parish. While attending Home Group Meetings, service projects and Parish Center & teen space activities, I hereby agree to RELEASE, INDEMNIFY, AND HOLD HARMLESS, St. John of the Cross Parish, its employees and agents, the Archdiocese of Chicago, and the Catholic Bishop of Chicago, (a corporate sole) form any and all liability which may arise from my child’s participation in the above mentioned activities. Liability to extend to any accidents, illnesses, or injuries (including the possibility of death) which may either directly or indirectly befall my child while participating in the above mentioned programs.

I give permission for Crossroads representatives to send reminders & contact my son/daughter via email, cell phone, text message, and facebook modes of communication.

In the event that a medical emergency shall befall my child, I now provide the Adult Crossroads Leader, the ACTING POWER OF ATTORNEY, to initiate and oversee any emergency medical care that may be deemed necessary on my child’s behalf until a time when I may be present to authorize the same. To assist in the administration which maybe necessary:

Insurance Company Policy #

Policy in the name of:

Allergies/medical conditions/ medications:

Hospital Preference: Dr.

By typing your name below, I hereby attest that I have read, understand, and agree to ALL of the above provisions.

Registration Info

Yearly Program fee: $115 first child, $85 every other child currently involved
Checks payable to: Crossroads Youth Ministry
Return to Parish Center: 5005 S. Wolf, Western Springs, IL 60558

Please complete all blanks ensure future communication!

Teen’s name: birth date: Month: Day: Year:

Teen’s email:

Teen’s Cell #: .. Home Phone #: ..

Parent(s) Cell #: ..

Parent(s) email(s):

Check your year in the fall:



Write your Home group name:
(NOTE: Freshman leave this blank, freshman will gather together to begin the year & divide into small groups in later fall)

High School you will attend in fall:

TEEN Programming CHOICES: Check any activities or Ministries in which you’d like to be involved:
Crossroads Advisory: details below, please fill out
Teen & Young Adult Choir: details below, please fill out
Lector/Commentator: read at mass, training to be scheduled in early fall
Eucharistic Minister: distribute communion, training scheduled in early fall

CROSSROADS ADVISORY EXPLANATION
This group is made up of teens who act as representatives to their home groups, providing information for planning and evaluating activities. We meet once a month in the Teen space & report back regularly to the advisory & your home group. You will obtain leadership training and experience while helping guide & lead our ministry. Please fill out the interest questions below & we will contact you with information.

CROSSROADS ADVISORY INTEREST QUESTIONS:
1) Why does the Crossroads Advisory group interest you?

2) What can you contribute to this group?

3) What was your favorite experience either with confirmation preparations or through Crossroads last year?

 

TEEN & YOUNG ADULT CHOIR EXPLANATION
This group helps provide music (vocal & instrumental) at the 5pm Sunday mass. They perform twice a month and at occasional special moments, i.e. First Communion. If you enjoy singing or playing and want to share that talent with your parish this is a great place for you! Please fill out your interests below.

CHOIR INTEREST QUESTIONS:
1) Why does this Choir interest you?

2) What previous singing or instrumental experience do you have?

3) What has been your favorite musical experience at a mass?