Life is Very Good Evening of Prayer

For High School Teens

Thursday, January 18, 2023

Meet at All Saints at 6:00pm
Return to All Saints by 10:30pm
Cost is $15

We have limited space, so please submit the form below by January 17 at 5:00pm. If you have questions, contact us.

NOTE ABOUT PAYMENT: If you think you may have already registered, please check your email for a “Thank you” from [email protected]. In the event of double registration or cancellation, any refund issued will be charged a 3.5% processing fee. Requests for cancellation received after the registration deadline cannot be refunded unless there is a waiting list.

"*" indicates required fields

Participant's Name:*

First Last

Are you already fully registered for this year's High School Youth Ministry Program?*

Yes, I'm already registered for high school ministry!

No, I'm not registered yet.

You must be fully registered for our 2022-2023 high school youth ministry program to participate in this event. Please CLICK HERE TO REGISTER (opens a new window for you). You must be registered via that page first in order to complete this event registration.

Have you completed the High School Ministry registration linked above?*

Yes, I have completed high school ministry registration.

No, I have not, and I understand I cannot register for this event until I do.

Date of Birth:*

School:*

High School Graduation Year:*

Address*

Street Address City State ZIP Code

Participant's Email:*

Enter Email Confirm Email

Participant's Phone:*

Emergency Contact Name:*

First Last

Emergency Contact Phone:*

Family Physician:

Physician Phone:

Please list any medical concerns (e.g. allergies) that your child has and that we need to be aware of:

List any medication your child will need administered on this outing:

Please agree to the following

As parent/guardian I agree to indemnify the All Saints Parish, Youth Ministers, Volunteers, and the Diocese of Arlington for any costs or expenses arising out of my child’s participation in the outing described above, including the cost of any medical care given my child or any expenses or fees incurred in any lawsuit arising as a result of any damage or injuries caused by my child in the course of his or her participation in the activity. I further give my consent to that in my absence the above-named minor be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment of the above minor. I have not been given a guarantee as to the results of examination or treatment. I authorize the hospital or medical facility to dispose of any specimen or tissue taken from the above-named minor. I authorize the All Saints Youth Ministry to use my child’s picture or video recording for educational and/or marketing purposes. Parents/guardians who do not wish their child to be photographed or filmed should so notify All Saints Youth Ministry in writing.

Parent/Guardian Signature:*

Please sign in the box above using your mouse (or your finger if you're on a tablet).

Print Your Name:*

Parent/Guardian Email:*

Enter Email Confirm Email

Payment

Would you like to save yourself time and pay the registration fee online right now?*

Yes, I'll save time and pay securely right now!

No, I'll give you a check.

Note: Because demand is usually high for our events, your registration will NOT be fully confirmed until we have received payment.

(Our online payment system is 100% safe and secure. We do NOT store any of your credit card information. We respect your privacy!)

High School Events

Price:

Billing Details

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Credit Card

Card Details

Cardholder Name

Billing Address:

Street Address Address Line 2 City State ZIP Code

Total:

Check Payment Instructions

Please make your check payable to "All Saints Youth Ministry"

Drop off in person: All Saints School or Parish Office.

Or mail to: All Saints Youth Ministry, 9300 Stonewall Rd, Manassas, VA 20110

Remember, because demand is usually high for our events, your registration will NOT be fully confirmed until we have received payment.

Total Due:

For High School Teens