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Brunswick Mission
2010
(June 21st - 25th)
This summer, you have the opportunity to impact your community with the power of the Gospel.
We will be serving our area through service projects and community restoration. This year we will again be partnering with other local ministries and the city to help clean up the Norwich corridor ‘North’ in Brunswick! In the evenings we will have some planned activities. We will be spending the night at St. William each night after our day of service. Mark your calendars for this fun week of service.
Your Cost: $20.00 non-refundable
This trip is open to all Middle and High School students
Need more info? Call Laurie: 912-638-7040 - lauriejones08@bellsouth.net
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2010 Brunswick Mission - Registration Form
Please return form with payment in full ($20) by Sunday, May 30th
Name:_________________________________ T-shirt size:____________
Parent Name:__________________________
Address:_________________________________________________
Emergency contact name and phone:________________________________
I, ____________________, (Parent name) give permission for____________________, (Student name) to participate in the 2010 Brunswick mission trip.
OVER
St. William Catholic
Church
Parental Release Form
Photo Release for Internet and Newspaper:
I hereby grant permission to St. William Catholic Church for photographs or video images taken of my youth (name) _________________________________________ during this program to be used to publicize St. William Catholic Church events and functions. My child’s name may / may not (circle one) be used along with the image.
Parent / guardian signature:
___________________________________________ Date: ______________
General / Medical Release:
I agree on behalf of myself, my minor dependant named herein, our heirs, successors, and assigns, to hold harmless and defend St. William Catholic Church and the Diocese of Savannah, its officers, employees, agents, chaperones, or representatives associated with the program from any claim arising from or in connection with my child attending the program or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors, employees, and agents, and the Diocese of Savannah, its employees, agents, and chaperones, or representative associated with the program for reasonable attorney’s fees and expenses which they may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the parish/Diocese. Further, I assume all responsibilities for the conduct of my minor during the above program.
I have read and understand the statement above.
Parent / guardian signature: ___________________________________________ Date: _______________
