Bowling: (St. Augustine Parish, Barberton)

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BOWLING

(St. Augustine Parish, Barberton)


MONDAY, JULY 10, 2017

This form is due in no later than Thursday, July 6.


Come join us for an evening of bowling! We will be bowling at Charger Lanes in Norton (1213 Norton Ave, Norton,
OH 44203). We will be bowling from 7:00-8:30. We will meet there and leave from there.

Cost is $3.50 a game and $3.00 for shoes. Teens should bring money with them to pay, and extra if they want any snacks.

What to Bring:
Money to bowl/eat and yourself!
Please KEEP the top section as your reminder!!

Please return this section and parent signature by Thursday, July 6 to Miss Jackie.

I, ________________________________, am the ________________________________ of


(Name of Parent/Guardian) (Father, Mother, etc)

_______________________________, a participant in the Bowling Event.


(Students name)
I hereby request permission for the above named child/children to attend the St. Augustine Bowling Event and I consent to the childs participation in
this retreat. I understand that I must provide transportation to and from the Church for my child. I hereby assume all risks in connection with the
youth event and I further release discharge, and/or otherwise indemnity the Diocese of Cleveland, the Bishop of the Roman Catholic Diocese of
Cleveland, St. Augustine, employees and volunteers from all claims, judgments, liability by or on behalf of my child, my self and my spouse for any
injury or damage due to the childs participation in the youth event, including all risks connected therewith whether foreseen or unforeseen.
Furthermore, I acknowledge that it is my responsibility to provide adequate health insurance for my child/children. I understand I have the
opportunity to call Jaclyn Snyder at 330-745-1080 and ask her about the youth event.

Please fill out a current Medical Release Form if you have not done so for the 2016-2017 school year.

Childs Name _________________________________M/F?

Age ____ School _______________

Address__________________________________ City __________________

Teens Cell Phone# _______________________Home Phone#___________________________

Parents Cell/Emergency#__________________Parents E-Mail_____________________________

Signature of Parent/Guardian__________________________

Allergies _____________________________________________________________________
Please list any health problems you may have and any medications being taken at the present time. (Confidential)

____________________________________________________________________________

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