YOUTH MINISTRIES REGISTRATION FORM LIABILITY RELEASE AND MEDICAL INFORMATION

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1 YOUTH MINISTRIES REGISTRATION FORM LIABILITY RELEASE AND MEDICAL INFORMATION Ministries in which you would like your child to participate. Please check mark those that apply: ALTAR BOYS (8+) MYROPHORES (Girls under 13) LITTLE ANGELS CHURCH SCHOOL GREEK SCHOOL HELLENIC DANCERS HOPE AND JOY GOYA YOUTH CHOIR CHILD (PARTICIPANT) INFORMATION FULL NAME : BAPTISMAL NAME: NAME DAY : GRADE: AGE: DOB: GREEK SCHOOL only Does this student speak Greek at home? Yes No STREET ADDRESS: CITY: STATE: STUDENT S CELL PHONE: ( _ ) _ - ZIP: Has this student received previous instruction in the Greek language? Yes No Classes are every Wednesday at 6:00pm beginning September 5th The Greek School is a tuition based school For further information, please call Natasha Smith: 941-727-8824 PARENT / GUARDIAN INFORMATION I understand that participation in the above youth ministry groups will involve social events and/or outdoor activities, on and off the premises of St. Barbara Church, any of which could possibly lead to physical injury to my child, even caused by the negligence or carelessness of advisors, chaperones, drivers, participants or volunteers of St. Barbara Greek Orthodox Church, or their agents (referred to as the Sponsors ). In consideration of permitting my child to participate in these activities, however, I agree to the following: 1. I agree to assume all risks of injury to my child. I understand that travel and participation in some athletics may result in severe injury, including paralysis, or death. 2. I agree to hold harmless and indemnify the sponsors, the officers and members of the parish council, all employees, agents, and stewards of the St. Barbara Greek Orthodox Church, of any and all liability in connection with any activity described hereinabove that my child participated in, which may result in any injuries of any kind to my child.. I hereby authorize the Sponsors to obtain, through a physician of their own choice, any emergency care that may become reasonably necessary for the student in the course of activities or travel. Payment of all charges incurred for medical treatment is guaranteed by me or the insurance company providing coverage for the above-named child. I hereby certify that I have read BOTH SIDES of this form and understand the rules contained herein, and that the information supplied is true and correct to the best of my knowledge. I accept the responsibility to inform the Sponsors of any future change of this information. PARENT / GUARDIAN NAME: ADDRESS SAME AS ABOVE ADDRESS DIFFERENT FROM ABOVE: ( _ ) _ - ( _ ) _ - PHONE: CELL HOME EMAIL: IN THE EVENT PARENT/GUARDIAN CANNOT BE CONTACTED, PLEASE CALL: PARENT/GUARDIAN SIGNATURE NAME: PHONE: 1 ( _ ) _ - RELATIONSHIP: DATE: / /

2 HEALTH INSURANCE AND MEDICAL INFORMATION Personal Medical Insurance Company Insurance Company Address City State Zip Name of Covered Insured Insurance Policy # Identification Number of Insured Current medications List any allergies List any sensitivities Limitations Asthma Diabetes Epilepsie/Seizures Immuno-compromised If any other medical problems, please list: PHOTO AND VIDEO RELEASE Representatives and authorized contractors of the Church are hereby authorized to take and record photographs, videotape or other images, and or make audio, video or other recordings, of Participant and Participant s activities at or involvement in Church Events, or using Church Property and Equipment, solely for use by the Church in its brochures, newsletters, video tapes, recordings, web sites and other promotional material or items to promote the Church or Church Events, all without any remuneration to Participant, Guardian or the Undersigned of this form. Initials: DONATIONS / TUITION (I would like to make a donation / payment for ) CHECKS PAYABLE TO (CASH EARMARK FOR ) AMOUNT RECEIVED BY (signature) HELLENIC FOLK DANCERS St. Barbara / Hellenic Folk Dancers $25 Ms. Maria Kirlangitis GREEK LANGUAGE SCHOOL TUITION St. Barbara / Greek School Kyria Natasha Smith - Principal CHURCH SCHOOL St. Barbara / Church School Ms. Sarah Ameres GREEK ORTHODOX YOUTH OF AMERICA St. Barbara / GOYA Mr. Dino Balos Please leave this part of the form at the registration table or submit it to the Church Office. 2

3 Detach this part of the form and take it home for future reference. Remember that your T.T.T.* stewardship commitment keeps our ministries alive. If you have NOT done it yet; please, fill in a 2018 Stewardship Pledge card today and renew it faithfully every year! (Matthew 6:21) 3 GREEK LANGUAGE SCHOOL Classses are once a week on Wednesdays at 6:00pm starting September 5th Our Greek School follows the vacations and breaks schedule of the public schools. The Greek School program is Church affiliated and the students will participate in Greek Orhtodox services on few ocasions during the school year. For details and additional information please contact our Greek Language School Principal Kyria Natasha Smith at (941)727-8824 or email: yellowtop03@msn.com CHURCH SCHOOL SCHEDULE OF SESSION ENTER CHURCH PREFERABLY 9:30AM, LIGHT CANDLES AND VENERATE THE ICONS / GOSPEL SIT IN FRONT LEFT HAND PEWS WITH YOUR FAMILY so you are better able to participate in the service and hear Father John s sermon for the day. RECEIVE COMMUNION, THEN WALK TO NARTHEX to meet your teachers who will escort you to class. DURING CLASS TIME: Welcome and Attendance Opening Prayer Lesson of the Day Lesson Activity or Game Discussion Learn by Hearth - prayers or Bible verses. Those students that memorize them will be acknowledged in the Weekly Bulletin and in the Pyrgos. Here Is My Blog About - saint name or topic (homework) at the end of each semester we may have the best works read publicly and published in the Pyrgos. PARENT PICK UP AND SIGN OUT * T.T.T. - Time (coming to services and Church activities as a good Greek Orthodox Christian) Talents (volunteering your talents and knowledge as any type of work, committees, boards, teaching etc.) Treasure (giving back to God some of your financial gifts according to the blessings you received)

4 Church School Session Schedule: TEACHER s and PARENT s GUIDE ALL LEVELS (The parents should work with their children at home praying daily and helping them memorize the prayers, the Scripture verses and writing the blog on the assigned saint for the semester) WELCOME, SIGN IN OPENING PRAYER Children will sign themselves in for the day. In the case of younger students, the teacher may mark each attending child as present. To set the tone for the class, open each morning with a prayer appropriate to the class. For younger children: Dear God, please bless my parents and all those who love and care for me. Thank you for all the good things I have in my life. Amen For older children, the Our Father is appropriate. LESSON FOR THE DAY ACTIVITY OR GAME Use this time to prep the children for the activity of the day. This can including reading a book, a passage, watching a short movie, or presenting a short lecture, depending on the age of the class and lesson plan of the day. (Please reference the Curriculum Guide for your class level to determine lesson plan) Each Lesson is accompanied by an activity (writing a reflection or singing a song, etc) a craft, or a game that ties into the lesson of the day. Children enjoy being actively engaged, and activities present additional methods of learning the material. Detailed instructions are contained within the lesson plan. DISCUSSION Please continue to discuss the topic of the lesson plan with your students as they work on their activity or game, if doing so will not distract them from completing the activity. You may also play our recorded church music CD in the background. 4

All prayers start with In the name of the Father and of the Son and of the 5 Holy Spirit and we make the sign of the cross. All prayers end with Glory to the Father and to the Son and to the Holy Spirit. Amen and we make the sign of the cross. Little Angels and PreK, Prayer: Jesus loves me that I know for the Bible tells me so. K, 1st and 2nd Prayer: God in Heaven hear my prayer keep me in your loving care. Be my guide in all I do. Bless all those who love me, too. 3rd and 4th Prayer: Our Father - the Lord s Prayer (Matthew 6:9-13) Scripture: Luke 18:15-17 (Let the children come to me) LEARN BY HEART FOR THE ENTIRE 2018-2019 SCHOOL YEAR 4th and 5th: Prayer: It is truly right to bless you, Theotokos, ever blessed, most pure, and Mother of our God. More honorable than the Cherubim, and beyond compare more glorious than the Seraphim, without corruption you gave birth to God the Logos. We magnify you, the true Theotokos. (Axion Estin) Scripture: Ten Commandments (Exodus 20:2-17) 7th, 8th and 9th Prayer: The Creed Scripture: Sermon On the Mount: the Beatitudes (Matthew 5:3-12) 10th, 11th and 12th Prayer: The Creed Scripture: Love - the most excellent gift (I Corinthians 13) HERE IS MY BLOG ABOUT... ASSINGNMENTS ARE FROM SEPTEMBER - CHRISTMAS EPIPHANY - MAY Students will keep a blog - journal type entries - with information that they find about a saint or any other given topic about faith. Topics are assigned as a whole year project allowing children enough time to research. The best work in each group may be published and/or presented in front of the congregation. These are the topics for 2018-2019 FIRST SEMESTER SECOND SEMESTER - K, 1st and 2nd Grade: The Most Holy Virgin Mary - oral story! Both semesters - 3rd and 4th Grade: St. Katherine St. George - 5th and 6th Grade: St. Barbara St. John the Baptist - 7th, 8th, 9th: St. Nicholas St. Anthony the Great - 10th, 11th, 12th: St. Stephen St. Athanasios PARENT PICK UP AND SIGN OUT Parents must pick their children up from Church School, before attending coffee hour. Parents must sign their children out of the classroom to ensure safety of our children. 5 CHURCH SCHOOL LIGHT CHURCH SCHOOL TEACHERS AND PARENTS PLEASE BE AWARE OF THIS NEW APPROACH OF A PERMANENT WEEKLY SESSION IN GUIDING OUR CHILDREN TO CHRIST. WE NEED YOUR FULL SUPPORT! Church School Light - means that there is no vacation! During the public school vacations or breaks we will still have Church School. All the children attending services should go in a classroom for Bible / faith story telling, discussion or activities. We will arrange that every Sunday we have at least a Church School teacher in church that may be able to care for the children in attendance. Light means that we allow more room for interaction, songs, stories or talents that children may want to share, fun games or activities, watching faith related video lessons or movies.

6 Notes and Reminders 6