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Sundae Sunday at the Country House Residence
(5030 S 155th St, Omaha, NE 68137; Please meet at site!)

Sunday, March 31, 2019 from 1:30 PM-2:30 PM

*This service opportunity is open to all 6th-12th grade teens; Parent participation welcome!

Due to limited space,  we will need to cap the number of volunteers for this opportunity.

WHAT: It’s Sundae Sunday! We are looking for a few fun individuals to serve ice cream sundaes to the residents of Country House, as well as to enjoy conversations and play games with them afterwards. We ask that volunteers meet at Country House (1 block south of 156th and Q) at 1:30 PM. Parents are invited to join in on the fun!

WHERE: The Country House Residence (5030 S 155th St, Omaha, NE 68137; Please meet at site!)

WHEN: Sunday, March 31, 2019 from 1:30 PM-2:30 PM

I grant permission for my child to participate in this parish youth ministry event located away from the parish site. This activity will take place under the guidance and direction of the parish employees and/or volunteers from St. Stephen the Martyr Parish. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor (“participant”). I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Stephen the Martyr Parish, its officers, directors and agents, and the Archdiocese of Omaha, chaperones, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of any medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors and agents and the Archdiocese, chaperones, or representative associated with the event for reasonable attorney’s fees and expenses arising in connection therewith. 

YOUTH: I understand that I am a representative of St. Stephen the Martyr Parish and the parish youth program. I will conduct myself in a manner, which will reflect a positive image of the parish, the youth program, and myself. If I behave inappropriately, I understand that my parents may be called and asked to take me home early. 

Photo Release: Pictures of my child taken during the event may be used in print or electronic media for the purposes of publicity for future events, unless I indicate to the Director of Youth Ministry in writing to the contrary.

Questions or concerns? Contact Laura Bogue, Youth Ministry, at 402-861-4509 or at l.bogue@stephen.org. 

Today's Date: March 21, 2019

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 19 years of age or older
First Participant's Information

Grade:

Youth Email:
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Grade:

Youth Email:
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Grade:

Youth Email:
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Grade:

Youth Email:
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Grade:

Youth Email:
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Grade:

Youth Email:
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Grade:

Youth Email:
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Grade:

Youth Email:
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Grade:

Youth Email:
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Grade:

Youth Email:
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 19 years of age or older
Parent or Guardian's Information

Grade:

Youth Email:
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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