High School Youth Group Registration: 2026-27

St. John Paul II Youth Group

The SJPII High School Youth Ministry is a High School Aged (grades 9-12) Youth Discipleship Group that seeks to support all the youth of the parish in their faith walk with Christ.

*Our first meeting will be Monday, September 28th from 6:30-8:40pm!

If you know someone who you want to invite to youth group, please invite them! This is for any and all High Schoolers to come have fun and have fellowship and share their faith.

We are also looking for adult help. If you would like to help in any way, please reach out to Katie Holmes, our new Youth Ministry Coordinator, at ymc@nocateecatholic.com. We are looking for all kinds of assistance, so please reach out.

Program Fee Information

High School Youth Group: $50

Family Maximum Program Fee: $350
This is the most you would give as a family. If your total is higher than this, please only give this amount. Select "previously paid family max" on the other forms so that you do not have to give again.

If you are unable to pay in full, please know that assistance is available. Please contact the Family Life Coordinator, Dominic Salamida, for assistance at flc@nocateecatholic.com or 904-330-0153.

Student Information

Student First and Last Name

Nickname

Gender

Male Female

Student Phone

Student Email

Student Birthdate

Grade Student Will Enter in 2026-27

School Attending for 2026-27

Has this child been baptized?

Yes No

Has this child been confirmed?

Yes No

Does your child have special needs?

Yes No

If you answered yes to the previous question, please fill out a special needs survey HERE.

Please Note Any Special Learning Needs Here:

Allergies:

Other Medical Conditions Or Disabilities:

Parent/Guardian Information

Mother's/Guardian First and Last Name

Father's/Guardian First and Last Name

Address

Primary Cell Phone

Primary Email address. Please provide a valid email that is checked regularly.

This address will receive a confirmation email

Please list here any additional email that you would like to receive communication.

Emergency Contact Name and Relationship

Emergency Contact Phone

Are you a registered parishioner?

Yes No

As a parent, I would like to be involved in youth group: Core Team (small group leading/event planning team) Providing a meal Office help Not now, but in the future

How can we pray for your teen and your family?

Family Medical & Health Care Information

Physician's Name

Physician Phone Number

Family Health Plan Carrier

Family Health Plan Number

Waivers

MEDICAL RELEASE:
MEDICAL MATTERS: I hereby warrant that to the best of my knowlage, my child is in good health, and I assume all responsibility for the health of my child.

EMEGENCY MEDICAL TREATMENT: In the event of an emergency, I hereby give permission to St. John Paul II Catholic Church and the Diocese of St. Augustine's employees, volunteers, or representative to seek medical treatment for my child above the physicain selected by St. John Paul II Catholic Church and The Diocesan representatives or volunteers to hospitalize, secure proper treatment for, and to order injection and/or anesthesia and/or surgery for my child above named.

I give my consent for the medical release and emergency medical treatment.

Parent Signature

Today's Date

PHOTOGRAPHY RELEASE
MINOR PHOTOGRAPHY RELEASE FORM:

Without compensation, I hereby grant the Catholic Diocese of St. Augustine (the “Diocese of St. Augustine”), its ministries, parishes, schools and other affiliated entities, permission to record my child’s appearance, physical likeness and/or voice on videotape, on film, or digital video disk, or other means, and/or take photographs of my child. Notwithstanding any prohibition as may be contained in Section 540.08, Florida Statutes, I hereby freely and voluntarily consent to the use, reproduction, and distribution of photographs, video recordings or other media capturing my child’s image, physical likeness, or voice for an indefinite period of time or until such time I expressly revoke my consent in writing. These materials may include, but are not limited to news, editorial content, publications, promotional materials, electronic media (websites, social media channels, podcasts, videos), and/or printed brochures.

In addition, I understand and agree that:

 The Diocese of St. Augustine, its ministries, parishes, schools, and other affiliated entities may alter, edit or modify these materials as needed, without restriction.

 The Diocese of St. Augustine retains the sole ownership and right to copyright any such materials.

 My consent is voluntary, and I waive any rights to inspect or approve the finished products or the specific use of such materials.

I agree to hold the Diocese of St. Augustine, the Bishop of the Diocese of St. Augustine, its employees and agents, and any media outlet or representatives involved in the creation of distribution of the materials harmless against claim, liability, loss, or damage caused by, or arising from any claims, demands or liability arising from or related the creation, use, production, or distribution of these materials. This Photography and Media Release Form for Minor Children is binding and applies to any claims of defamation, invasion
of privacy, or rights of publicity.

I have read this Photography and Media Release Form for Minor Children before signing and fully understand the contents, meaning, and impact of this release. I understand that I am free to address any specific questions and have done so prior to signing this release.

I give my consent for the Minor Photography Release.

Parent signature

Today's Date

Program Fee

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

High School Youth Group Registration: 2026-27

Description

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