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2025-2026 Children's Ministry

for PK-5th Graders

approximately 2 Sundays per Month

9 a.m. to 10:15 a.m. at Our Lady of Grace Church 

Registration is required for participation in Children's Ministry.


To keep a safe and fun environment for everyone, and for minor's to be left in the care of staff and leaders of Our Lady of Grace, it is mandatory for us to have the everyone's contact information, health concerns, and signed waivers on file. A family may register all of their children (PK-5th) or Teen Helpers on one waiver. 

NAME OF THE MINISTRY: Children's Ministry

DATES OF THE MINISTRY: see schedule

NAME OF PARISH HOSTING THE MINISTRY: Our Lady of Grace Church

ADDRESS OF PARISH HOSTING THE MINISTRY:

1011 Mount Pleasant Road, Greensburg, PA 15601

ON-SITE MINISTRY SUPERVISOR: 

Stephanie McCarthy, Coordinator of Children's Discipleship & Evangelization

CONTACT INFORMATION FOR ON-SITE MINISTRY SUPERVISOR: 

724-838-9480 x 17  or   smccarthy@dioceseofgreensburg.org

TRANSPORTATION: NONE

REGISTRATION PAYMENT:

    This helps to offset the cost of the materials

    1 Child: $30          2 Children: $55           3+ Children: $80

Payments can be made online, with cash, or by check.*

To pay by cash or check, place your payment in an envelope labeled 

ATTN: ITZIA-CM Payment and:

  • drop it off at the Our Lady of Grace Office during office hours
  • drop it, if after office hours, in the black drop box by the front office door 
  • drop it in the weekend collection basket at OLG
  • mail it to Children's Ministry, 1011 Mount Pleasant Road Greensburg, PA 15601
  • drop it off at the Welcome Center at the weekend Masses

*All checks should be made payable to Our Lady of Grace Church

To pay online, go to: https://www.osvhub.com/ourlady-of-grace-church/forms/20252026childrensministry


ON-SITE EVENT CONSENT

I hereby consent to participation for the above named child(ren) in the ministry described above. I understand that this ministry will take place on the Church grounds and that my child(ren) will be under the supervision of the designated parish employee on the stated date(s). I further consent to the conditions stated above on participation in this event. In case of emergency, we give permission for our child(ren) to be treated at a hospital and/or by a medical doctor.

In consideration for providing my child(ren) the opportunity to attend formation and parish activities, both my child(ren) and I voluntarily agree to release and agree to hold PARISH AND DIOCESE OF GREENSBURG harmless from, and waive on behalf of myself/my child(ren), my heirs, and any personal representatives, any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself/my child(ren) that may be caused by any act, or failure to act of the PARISH AND DIOCESE OF GREENSBURG or that may otherwise arise in any way in connection with my child(ren)’s attendance at a parish event to the fullest extent allowed by law.

I understand that this release discharges the PARISH, AND DIOCESE OF GREENSBURG from any liability or claim that I/my child(ren), my heirs, or any personal representatives may have against the parish/ diocese with respect to any bodily injury, illness, death, or medical treatment that may arise from, or in connection to, my child(ren)’s attendance at the parish or event.

This liability waiver and release extends to the PARISH, AND DIOCESE OF GREENSBURG together with its clergy, staff, and volunteers.

I certify and represent that I have the legal authority to waive, discharge, release, and hold harmless the released parties on behalf of myself and the above-named student.

I Agree



PHOTOGRAPHIC RELEASE

I hereby grant to Our Lady of Grace Parish, Greensburg, Pennsylvania, and its respective licensees, successors and assigns, the right and permission, with respect to those photographs taken of the minor named below on whose behalf I am signing, and with respect to any printed or electronic matter in connection therewith, to do the following: To include such photographs on the Our Lady of Grace website, social media, and on print material (names of minors are not used for web or print media/publications without prior consent)

I hereby release, discharge and agree to indemnify and hold harmless the Diocese of Greensburg and its legal representatives, licensees, successor and assigns, from all claims and demands whatsoever arising out of or in connection with the foregoing, and waive any right to inspect or approve the same.

I hereby certify that I am the parent and/or guardian of the above said minor/s under the age of eighteen years, and hereby consent on behalf of said minor to the use of any of the photographs taken of said minor pursuant to the terms set forth in this Photographic Release, including, without limitation, the release, discharge and hold harmless provisions thereof.

I AGREE to the Photo Release
I DO NOT Agree to the Photo Release
First Child's Name
First Name*
Last Name*
Select Gender
First Child's Date of Birth*
Date of Birth
First Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
First Child's Signature*
Second Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Second Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Third Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Third Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Fourth Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Fourth Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Fifth Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Fifth Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Sixth Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Sixth Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Seventh Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Seventh Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Eighth Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Eighth Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Ninth Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Ninth Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Tenth Child's Name
First Name*
Last Name*
Select Gender
Child's Date of Birth*
Date of Birth
Tenth Child's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
Parent or Guardian's Email Address
Email*
Confirm Email*
Insurance
Insurance Carrier*
Insurance Policy Number*
Primary Contact
First Name *
Last Name *
Address *
Email *
Primary Phone Number *
This number is a*
Secondary Phone Number (if you have one)
This number is a
The primary contact is the child's:*
Secondary Contact
First Name *
Last Name *
Address (if different from the Primary Guardian)
Email *
Primary Phone Number *
This number is a *
Secondary Phone Number
This number is a
The secondary contact is the child's*
FAMILY INFORMATION: Custody/Divorce/Separation Situations
Are the child's parents divorced?*
No
Yes
If you answered yes, what is the child's primary address?
Are there any concerns/situations that we should be aware of pertaining to the safety/security of this child?
For your child's safety, is there anyone who is NOT permitted to be with them? (if you have a supporting legal document, please provide)
Are you a parent/guardian interested in helping?
I would like to.....(please check all that apply)
Small Group Leader
Small Group Assistant
Material Preparation (at home)
Sunday Setup
Sunday Clean-up
VBS Planning Team (for Summer 2026)
Who is interested in helping?
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant

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.



By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Relationship*
Select Gender
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
School Attending *
Grade Level for Fall 2025-2026*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other
If other, what is your parish of registration?
Sacraments the child HAS ALREADY received (check all that apply) *
Baptism
First Holy Communion
Confirmation
None
My child has a food allergy*
No
Yes
If answered yes to food allergy, please list/describe the allergy and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes
If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes
If answered yes to learning disability, please list ALL learning disabilities. This information is to assist us in forming your child adapting the material. Your privacy will be respected.
My child has a medical condition*
No
Yes
If answered yes to medical condition, please list ALL medical conditions
Please list any special accommodations that your child may need
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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