PARENTAL PERMISSION FORM

This form MUST be completed by the parent/guardian and mailed to Generation Life no later than June 29, 2009.  No one will be permitted to participate in the Theology of the Body for Teens summer session without the submission of this form.

Theology of the Body for Teens summer sessions: (Please check the one that applies.)

q BUCKS COUNTY LOCATION - Tuesdays, July 7-August 11 - 7-8:30PM

        St. Bede the Venerable - Drexel Center

        1071 Holland Rd.

        Holland, PA  18966

q CHESTER COUNTY LOCATION - Wednesdays, July 8-August 12 - 7-8:30PM

        SS Peter & Paul - Parish Hall below the church

        1325 Boot Rd.

        West Chester, PA  19380

q PHILADELPHIA LOCATION - Thursdays July 9-August 13 - 7-8:30PM

        Our Mother of Sorrows - Church basement.

        1020 N. 48th St.

        Philadelphia, PA  19131

              I grant my permission for my son/daughter, ________________________, to participate in the Theology of the Body for Teens summer sessions as indicated above.  The six week sessions will present Pope John Paul II's compelling vision for love and life, as it pertains to our sexuality and one's vocation. Sessions will include facilitator presentations, group discussion & fun activities.  For more information, go to www.TOBforTeens.com.

TOB is planned and supervised in a conscientious way.  The Office for Youth and Young Adults and Generation Life trust that as young Catholic women and men, all the participants will behave maturely.

NAME of Attendee: __________­______________________________  GRADE:________________________

ADDRESS: _______________________________________________________________________________

(street)                                                                             (city)                           (state)                         (zip)

EMAIL:_________________________________________   PHONE:_________________________________

PARISH:   _______________________________________  YOUTH MINISTER:_______________________

If I cannot be reached in the event of an emergency, the following person is authorized to act on my behalf:

                  Name:       __________________________________________________________________________

                  Address:                  __________________________________________________________________________

                  Home Phone:          _____________________________________  Cell: _________________________

                  Relation to participant: _______________________________________________________________

                  Participant’s physician’s name:  ________________________________________________________

                  Phone number: _____________________________________________________________________

                  Health Insurance Type: _______________________________________________________________

                  Policy Number: _____________________________________________________________________

List any conditions, e.g. allergies, or other medical problems which should be called to the attention of the program facilitators:  ___________________________________________________________________________________________________

There will be no medication of any kind available.  Please be sure that your child has with them anything necessary for medical reasons and list it here:  _______________________________________________________________________________    

Knowing that there will be proper supervision, in case of injury, I will not hold the Office for Youth and Young Adults of the Archdiocese of Philadelphia or Generation Life or any person or persons connected with them liable. My signature below also gives OYYA and Generation Life permission to use pictures from the day in which my child appear for promotional materials.

Parent/Guardian Name:   _____________________________________              Telephone:  ____________________

                                          (Please print clearly.)

SIGNED: ________________________________________________             Cell Phone: ____________________

                                                     (Parent or Guardian)                

Teen signature:    _____________________________________________________________________________

Please mail this completed form along with the registration & fee to Generation Life, 560 Snyder Ave. West Chester, PA  19382.