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GBYC 2019 | REGISTRATION PACKET
PACKET INCLUDES:• EventDetails• SpeakerBios• RegistrationInfo• AdultLiabilityWaiver• YouthLiabilityWaiver
WearesoexcitedtobringbackGBYCforthisyearandtocelebrateitaroundthefeastoftheImmaculateConceptionattheNationalShrineofOurLadyofGoodHelpisextremelyspecial.WearebeyondblessedinourDiocesetohavetheonlyVatican-approvedMarianapparitionsite,especiallysincethemessageisallaboutcatechizingandevangelizingouryouth.
Wantingtooffersomethingsimple,dynamic,andhealingforallthosewhoattend,we’veselectedthetwoguestspeakersandwantedtopartnerwiththeShrineforthelocation.
We’rehopingtoexpanduponouruniversalcallasdisciplestobelovedbyGod,calledbyGod,andsentoutbyGod.Thetalksandoccurrencesforthedaywillreflectopportunitiestogrowdeeperinthiscommission—wearesoexcitedtoofferthisdayforourparishes,schools,andyouthofourDiocese!Our Lady of Good Help, pray for us!
Ifyouhaveanyquestions,needadditionalinfo,orarelookingforideasonhowtopromotethisevent,we’dbemorethanhappytohelp!
-Maximus&Callie
CALLIE KOWALSKIChild&YouthFaithFormationAssistantDir.(920)272-8285ckowalski@gbdioc.org
MAXIMUS CABEYChild&YouthFaithFormationDir.(920)272-8288mcabey@gbdioc.org
OFFICE OF CHILD & YOUTH FAITH FORMATION | (920) 272-8309 • YOUTHMINISTRY@GBDIOC.ORG
EVENT DETAILS• GreenBayYouthConference• Sunday,December8,2019• NationalShrineofOurLadyofGoodHelp• 9a.m.to5:45p.m.• Doorsopenat8:30a.m.forregistration• Cost:$15/attendee• Boxedlunchincluded• RegistrationDeadline:November1st
WantyouryouthtodeepentheirfaithorevenencounterJesusforthefirsttime?GBYCisanimpactfuldayforhighschoolstudentsthatincludestwokeynotespeakers,confessionsofferedthroughouttheday,separatebreakoutsessionsformenandwomen,ahealingservice,andSundayMass.
Learn more about who will be joining us at GBYC 2019!
SPEAKER BIOS
OFFICE OF CHILD & YOUTH FAITH FORMATION | (920) 272-8309 • YOUTHMINISTRY@GBDIOC.ORG
SISTER ANN IMMACULEE|TheSistersofLifeareconsecratedtoprotectandenhanceasenseofthesacrednessofhumanlife.ImmersedincontemplativeEucharisticprayer,withinavibrantcommunitylife,theSistersactinimitationoftheBlessedMother,bringingtheconsolingpresenceofJesusChrist,conceivedbeneaththeirheartstoeverypersontheymeet,especiallythosewhoselivesarehidden,weakorwounded.Theirmissionsincludecaringforvulnerablepregnantwomenandtheirunbornchildren;invitingthosewoundedbyabortionintothehealingmercyofJesus;fosteringaCultureofLifethroughevangelization;retreatworksatVillaMariaGuadalupeinStamford,CT;andupholdingthebeautyofmarriageandfamilylife.
PATRICK REIS|PatrickistheExecutiveDirectorofEncounterMinistriesandhasapassionanddrivetoseeCatholicsempoweredtowalkinthepowerandloveoftheHolySpirit.Hecarriesastrongheartforevangelization,propheticministryandChristianunity.Patrickministersandspeaksatconferencesinternationallyandwasfeaturedinthegroundbreaking“Fearless”documentaryandtheupcoming”Revive”documentary.HeismarriedtoEmilyandtogethertheyhavesixchildren.
SONAR WORSHIP|ACatholicbandfromSt.Paul,Minnesota,withrootsinmanygenresfromelectronicdancemusictorockandpoptocountryandbluegrass.Theyareathomewithbothcontemporaryworshipandtraditionalhymns.Andwhetherit’sagatheringofafewhundredoraneventfortensofthousands,theyarealwaysstrivingtodrawothersdeeperintoworshipthroughtheirmusic.
ONLINE GROUP REGISTRATION|Toregisteronline,pleasevisitgbresources.org,clickthe“Events”tab,andselectGBYC2019.ThisonlineformshouldbecompletedbytheleaderoftheparishorschoolgrouplookingtoattendGBYC.
Help us pack the National Shrine of Our Lady of Good Help’s new event center with 800+ high schoolers! Here’s how to register your group for the event:
REGISTRATION INFO FOR GBYC 2019
OFFICE OF CHILD & YOUTH FAITH FORMATION | (920) 272-8309 • YOUTHMINISTRY@GBDIOC.ORG
A FEW REMINDERS|Thisisahighschoolconference,sostudentparticipantsshouldbeingrades9-12currently.StudentsMUSTregisterwithaparishorschoolgroup.Ifstudentswishtoattendindependentlyfromagroup,theymustregisterwithanadultchaperone,parent,orguardian.Thereisnoindividuallostsheepoptionforstudents.
COST & PAYMENT|Eachparticipantcosts$15.OnegroupcheckcanbewrittentotheDioceseofGreenBayandbroughtwithyouatthetimeofcheckinonDecember8th;ormailedinoneweekpriortotheevent.Priests/clergy/religiousarefree.
LIABILITY FORMS|Itisthegroupleader’sresponsibilitytocarryalloftheindividualstudentliabilityformswiththem.TheDioceseofGreenBaywillnotbecollectingliabilityformsfromeachparishorschool.Eachgroupmustprovidetheirownadultchaperonesandhavetheiradultliabilityformsonhand.Oursafeenvironmentpolicyrequiresoneadultchaperone(21andover)pereightminors.Minimally,thereshallbeoneadultchaperoneforanymaleminorsandonefemaleadultchaperoneforanyfemaleminors.
REGISTRATION DEADLINE|November1,2019.Norefundswillbegivenafterthisdate.
MAIL-IN REGISTRATION|Ifyouareunabletocompletetheonlineregistrationform,pleasecontactusat(920)272-8309oryouthministry@gbdioc.orgorvisitgbresources.org(clickthe“Events”tab,andselectGBYC2019)foraPDFform.
PARISH/SCHOOL/GROUP YOU ARE REGISTERING UNDER:
__________________________________________________________________________________________
RELEASE OF LIABILITY/MEDICAL RELEASE:
I,_____________________________________________________(FullName),agreeonbehalfofmyself,myheirs,assigns,executors,andpersonalrepresentatives,toholdharmlessanddefend______________________________________________________(Parish/SchoolintheDioceseofGreenBay),DioceseofGreenBay,itsofficers,directors,agents,employees,orrepresentativesfromanyandallliabilityforillness,injuryordeatharisingfromorinconnectionwithmyparticipationinthetrip.IntheeventthatIshouldrequiremedicaltreatmentandIamnotabletocommunicatemydesirestoattendingphysiciansorothermedicalpersonnel,Igivepermissionforthenecessaryemergencytreatmenttobeadministered.
Please advise the doctors that I have the following allergies:____________________________________________________________________________________________________________________________________________________________________________________
In case of an emergency and for permission for treatment beyond emergency procedures, please contact:
Name:___________________________________________________________________________________
RelationshiptoMe:________________________________________________________________________
DaytimePhone:_____________________________NightTimePhone:_____________________________
HealthInsuranceCarrier:___________________________________________________________________
InsuranceIDNumber:_______________________InsurancePolicyNumber:_______________________
______________________________________________________________________________________
___________________________________________________________
EmailAddress:_____________________________________________________________________________
Signature Date
PrintName
Affiliation with the teens of your group (Circle all that apply):
Parent Youth Minister Catechist Teacher
Other_________________________________________________
OFFICE OF CHILD & YOUTH FAITH FORMATION | (920) 272-8309 • YOUTHMINISTRY@GBDIOC.ORG
Each adult participant, including group leaders and chaperons, must sign this form.
GBYC 2019 - ADULT LIABILITY WAIVER
Participant’sName:_________________________________________________DateofBirth:___________________Sex:___________________Parent/Guardian’sName:___________________________________________________HomePhone:___________________________________Businessphone:___________________________________I,_______________________________________________(ParentorGuardian’sName),grantpermissionformychild,
______________________________________________(Child’sName),toparticipateinthiseventthatrequires
transportationtoalocationawayfromtheparish/school/diocesansite.Thisactivitywilltakeplaceundertheguidanceanddirectionofparish/school/diocesanemployeesand/orvolunteersfromtheDioceseofGreenBay.
A Brief Description of the Activity is as Follows:Typeofevent:_____________________________________________________________________________________Dateofevent:____________________________________________________________________________________Destinationofevent:_______________________________________________________________________________Individualincharge:_______________________________________________________________________________Estimatedtimeofdepartureandreturn:______________________________________________________________Modeoftransportationtoandfromevent:___________________________________________________________
Asparentand/orlegalguardian,Iremainlegallyresponsibleforanypersonalactionstakenbytheabovenamedminor(“participant”).Iagreeonbehalfofmyself,mychildnamedherein,orourheirs,successors,andassigns,toholdharmlessanddefendthe:__________________________________________________________________(NameofParish)itsofficers,directors,employeesandagents,andtheDioceseofGreenBay,itsemployeesandagents,chaperones,orrepresentativesassociatedwiththeevent,fromanyclaimarisingfromorinconnectionwithmychildattendingtheeventorinconnectionwithanyillnessorinjury(includingdeath)orcostofmedicaltreatmentinconnectiontherewith,andIagreetocompensatetheparish/school,itsofficers,directorsandagents,andDioceseofGreenBayitsemployeesandagentsandchaperones,orrepresentativeassociatedwiththeeventforreasonableattorney’sfeesandexpenseswhichmayincurinanyactionbroughtagainstthemasaresultofsuchinjuryordamage,unlesssuchclaimarisesfromthenegligenceoftheparish/schoolortheDioceseofGreenBay.
Signature Date__________________________________________________________________________________
MEDICAL MATTERSIherebywarrantthattothebestofmyknowledge,mychildisingoodhealthandIassumeallresponsibilityforthehealthofmychild.(Ofthefollowingstatementspertainingtomedicalmatters,signonlythosethatareapplicable.)
EMERGENCY MEDICAL TREATMENTIntheeventofanemergency,Iherebygivepermissiontotransportmychildtoahospitalforemergencymedicalorsurgicaltreatment.Iwishtobeadvisedpriortoanyfurthertreatmentbythehospitalordoctor.Intheeventofanemergency,ifyouareunabletoreachmeattheabovenumbers,contact:
Name&Relationship:______________________________________________Phone:_________________________
Child’sFamilyDoctor:_________________________________________PhoneofDoctor:_____________________
FamilyHealthPlanCarrier:________________________________________Policy#:_________________________
Signature Date______________________________________________________________________________________
Medical Information and Parent/Guardian Consent Form/Liability Waiver
GBYC 2019 - YOUTH LIABILITY FORM (PG1)
MEDICATIONSMychildistakingmedicationatpresent.Mychildwillbringallsuchmedicationsnecessaryandsuchmedicationswillbewell-labeled.Namesofmedicationsandconcisedirectionsforseeingthatthechildtakessuchmedications,includingdosageandfrequencyofdosage,areasfollows:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
CHOOSE ONE OF THE FOLLOWING:1.Nomedicationofanytype,whetherprescriptionornon-prescription,maybeadministeredtomychildunlessthesituationislife-threateningandemergencytreatmentisrequired.
2.Iherebygrantpermissionfornon-prescriptionmedication(i.e.non-aspirinproductssuchasacetaminophenoribuprofen,throatlozenges,coughsyrup)tobegiventomychild,ifdeemedappropriate.
SPECIFIC MEDICAL INFORMATIONTheparish/schoolwilltakereasonablecaretoseethatthefollowinginformationwillbeheldinconfidence.Allergicreactions(medications,foods,plants,insects,etc.):_____________________________________________Doeschildhaveamedicallyprescribeddiet?__________________________________________________________Doeschildhaveanyphysicallimitations?_____________________________________________________________Youshouldbeawareofthesespecialmedicalconditionsofmychild:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Signature Date______________________________________________________________________________________
Signature Date______________________________________________________________________________________
Signature Date______________________________________________________________________________________
MEDIA RELEASEThisauthorizationformconstitutespermissionformychild(ren)’sparticipationinvideotapingand/orphotographswhichmaybetakenduringtheprogram/trip.Thesecouldbeusedforfurtherpromotionalvideos,websitepromotions,fliers,orotherdiocesanorparishappropriateuses.
**Please be aware that legally, the group leader can search any person’s room and/or possessions if there is suspicion of any illegal behavior.**
Signature of Parent/Guardian ___________________________________________________________
Medical Information and Parent/Guardian Consent Form/Liability Waiver
GBYC 2019 - YOUTH LIABILITY FORM (PG2)
OFFICE OF CHILD & YOUTH FAITH FORMATION | (920) 272-8309 • YOUTHMINISTRY@GBDIOC.ORG
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