Md missionary Disciples to Action Thursday August 3

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Calling All MD Missionary Disciples to Action

Thursday August 3

All incoming freshmen through outgoing seniors are invited to gather at Holy Family Catholic Church in Middletown for an evening of Worship, Social Justice Prep work, Fun, and Food.

Friday August 4

We all travel via bus to Downtown Frederick to serve all over the City

To Register: Turn in a registration paperwork plus $35 to your Youth Minister no later than Tuesday, July 18.


Drop off is at Holy Family 7321 Burkittsville Rd. Middletown at 4pm

Pick up is at St. John’s 112 East 2nd St. Frederick at 6:30pm

Pack for an overnight

Parents we need you to join us at service sites on Friday. Contact your YM if you can take a group of teens to serve.

iServe Thing to Pack

    • Sleeping bag/mat

    • Pillow

    • PJs (modest)

    • Rain jacket/poncho

    • Work boots or sneakers (no sandals or flip flips for service sites)

    • Personal toiletries (no showers)

    • Set of work clothes and set of (modest) hang-out clothes

  • Pair of Work gloves

  • Hat or bandanna

  • Camera, if desired

  • Bathing suit (modest, one-piece) & Towel

  • Water bottle with your name on it

  • Drawstring bag to carry to and from Sites

In case of emergency contact

Ana Maria 301-461-0304

Carpool: There is no carpool. Drop your teen off at Holy Family in Middletown MD on Thursday at 4:00 PM. Pick up is Friday at 6:30pm at St John’s in Frederick MD.

Things NOT to bring: Alcohol, drugs, tobacco products

Cell phones: will be taken away if they become a distraction

Any medication the teen needs should be in a plastic bag and given to the youth minister upon arrival with written instructions enclosed.

Dietary Needs:

If your teen has any dietary needs please let your youth minister know ahead of time so that arrangements can be made for meals.

Retreat Discipline Policy:

1. In cases of minor disruptions, teens will be warned and could be removed.

2. Major infractions, such as, drugs, alcohol, vandalism, sex or violence, will

result in the teen leaving iServe.

Providing the following information will help in the registration process for iServe.

Please indicate the TYPE OF SITE at which you would like to serve. Challenge yourself!

___ Children

___ Cleaning/Organizing

___ Elderly/Disabled

___ Light Manual Labor

___ Wherever
Teen’s T-shirt size: (adult sizes) _______________
___ I am interested in participating in this two-day service project in downtown Frederick, learning about social justice issues, and making new friends.
Please read and agree to the following:
1. Respect God –refrain from using God’s name in vain, keep in mind that you represent the Catholic community.

2. Respect People - control temper, avoid profane language, refrain from public displays of affection, dress modestly, abstain from illegal substances, respect other people’s property.

3. Respect Adult Guidance – remember that all adult chaperones have the authority to direct every youth at the event.

For the protection and safety of all of our participants, we ask that all parents or guardians inspect your young person’s belongings before traveling to iServe.  The policy of our parish and the Archdiocese of Baltimore, in accordance with the State of Maryland is that drugs, alcohol, and weapons of any kind are prohibited from ALL parish events.     In the event that a potentially dangerous or illegal situation were to  occur on any of our events, the parish staff /STAND trained chaperones reserve the right to verify/inspect the youth’s belongings, as well as notify the parent or guardian of the event and possible dismissal from iServe.   In the event illegal items are in the possession of a minor, parents and law enforcement will be contacted. If at any point we are concerned about the health and well-being of a young person EMS will be notified.   This policy is in the best interest of creating a safe and healthy experience for all participants and volunteers of our parish.   By signing below the teen and parent are agreeing to these conditions.

_________________________________ _________________________________

Teen Signature/Date Parent Signature/Date


If able to volunteer, please indicate your availability (time, days) : ______________________________________

Have you completed STAND training? ____ Yes ____ No Adult Volunteer T-shirt size: _______
If your child needs a scholarship, check here: ________ (please follow up with your youth minister)

Youth Name: ____________________________ Home Phone:_____________________ DOB _______ M or F

Parent Name: ____________________________ Cell Phone:_____________________

Address City/State/Zip: ____________________________________________________

In consideration of the wholesome recreational and learning experience in which my son/daughter will participate, I as parent or guardian of my son/daughter, do hereby agree to allow my son/daughter to accompany the youth ministry of my parish to iServe August 3-4, 2017, Frederick. Transportation provided by carpool I/we acknowledge receipt of the attached information sheet describing the planned activities. In consideration of the opportunity for my son/daughter to participate in the Program, I agree to RELEASE AND HOLD HARMLESS AND INDEMNIFY my Catholic church, the Division of Youth & Young Adult Ministry, the Roman Catholic Bishop of Baltimore and his successors, a Corporate Sole, and all their agents, servants and employees from any liability, claims, demands and causes of action arising out of or relating to any loss, damage or injury sustained in connection with or arising out of my son/daughter’s participation in the Program.

I hereby grant permission to any staff person to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that I cannot be reached.

(Check one of the following:)

 I am covered by hospitalization and medical insurance under policy

# ____________________________ Issued by: _________________________________________

 I do not have medical coverage and assume responsibility for the cost of hospitalization and medical care for my son/daughter.

I hereby grant permission to any staff person to provide the following over-the-counter drugs (or their generic equivalent) to my son/daughter if requested by my son/daughter. Circle all that apply.

Tylenol  Benadryl  Advil  Sudafed  Midol  Kaopectate  Neosporin Pepto Bismol

Any other medical information or concerns: __________________________________________________________

Medication, allergies: __________________________________________________________________________

Dietary restrictions: _____________________________________________________________________________

Parents/guardians of participants are advised that photographs or videotape of participants may be used in publications, websites or other materials produced from time to time by the Division of Youth and Young Adult Ministry or the Archdiocese of Baltimore. (Participants would not be identified, however, without specific written consent.) Parents/guardians who do not wish their child(ren) to be photographed or filmed should so notify the Division in writing. Please note that the Division has no control over the use of photographs or film taken by media that may be covering the event in which your child(ren) participate(s).

______________________________________ __________________________________________

Parent/Guardian Signature Date Youth’s Signature
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