St Andrew the Apostle Catholic Church and School |

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WAIVER OF LIABILITY FOR CORONAVIRUS/COVID19
- For St. Andrew's Saltire COVID-19 Safety Plan, click here.
- First and Last Name of Student REQUIRED Please fill out this field. Please enter valid data.
- 1. The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air. People reportedly can be infected and show no symptoms and therefore spread the disease. The exact methods of spread and contraction are unknown, and there is no known treatment, cure, or vaccine for COVID19. Evidence has shown that COVID-19 can cause serious and potentially life-threatening illness and even death.
  
  2. While St Andrew the Apostle Parish has implemented preventative measures, it cannot guarantee that you or your child(ren) will not be exposed to, contract, or spread COVID-19 while attending St Andrew the Apostle ministries or are present on the parish premises. It is not possible to prevent against the presence of the disease. Therefore, if you choose to utilize St. Andrew the Apostle and/or enter onto the parish premises, you and family members may be exposed to and/or increase the risk of contracting or spreading COVID-19.
  
  3. ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my youth to utilize the Parish ministries and enter the Parish premises. These services are of such value to me and/or to my youth, that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize the Parish ministries and the Parish premises in person [if applicable: “rather than arranging for an alternative method of enjoying the same services virtually (e.g. videoconference)].
  
  4. WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against the Parish and its owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing the Parish services and premises. I understand that this waiver means I give up my right and children’s right to bring any claims, including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.
  
  5. CHOICE OF LAW: I understand and agree that the law of the State of Missouri will apply to this contract.
  
  I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE AND ATTACHED ACKNOWLEDGEMENT, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE:
  
  I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release.
- Electronic Signature of Parent REQUIRED Please fill out this field. Please enter valid data.
- - While the Parish has put in place preventative measures to reduce the spread of COVID-19, the Parish cannot prevent that program participants or staff members may contract COVID-19.
  - I acknowledge and accept it is my responsibility to monitor my child’s health each day prior to their participation in programs at the Parish, including but not limited to taking their temperature daily, and keep them home if they exhibit any symptoms of COVID-19.
  - If my child or a family member with whom my child resides is diagnosed as infected with COVID-19, I agree to immediately notify the director of any program in which my child is participating in at the Parish and that information will be provided to those individuals who may have been exposed.
  - I likewise commit to educate and encourage my child to comply with social distancing requirements to promote the health and well-being of my child and others.
  - I understand if it is determined a staff member or participant of any program occurring at the Parish is infected with COVID-19, the Parish will be required to suspend, delay or terminate all programs occurring at Parish for such period of time as necessary to clean and disinfect exposed areas of the Parish.
  - I likewise understand programs may be suspended, delayed, or terminated due to increased occurrences of COVID-19 in the community.
  - I understand significant costs are incurred by the Parish to develop and staff programs. I understand fees paid in advance of my child(s) participation in programs at the Parish may not be refunded.
  - Any refund or reduction in fees due to any occurrence related to COVID-19 is the sole discretion of program directors at the Parish.
- I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release.
- Electronic Signature of Parent REQUIRED Please fill out this field. Please enter valid data.
STUDENT SALTIRE REGISTRATION
1. EVENT INFORMATION
- Registering for: (Note: All Confirmation and Rite of Christian Initiation Teens should check this box. REQUIRED Middle School Saltire High School Saltire Please fill out this field.
- If High School Saltire, then select ALL that apply for this student: Confirmation -- $25 registered parishioner Confirmation -- $75 non-registered parishioner Rite of Christian Initiation for Teens --see leader for fees Benedictine Brothers (high school boys) only $60 or free with Saltire membership Sanctimonia (high school girls) only $60 or free with Saltire membership N/A, this student has already been Confirmed
2. PARTICIPANT INFORMATION
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- (Confirmation Candidates Only) Middle Name Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Birthdate--MM/DD/YYYY format REQUIRED Please fill out this field. Please enter valid data.
- Life-Threatening Health Concerns or Food Allergy? Self-manageable? REQUIRED
  Any health concern the teacher should know about? Please elaborate on whether this condition is self-manageable and what precautionary measures need to be taken.
  Please fill out this field. Please enter valid data.
- Grade (2020-21) REQUIRED Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Please fill out this field.
- What school does student attend? REQUIRED Please fill out this field. Please enter valid data.
- Baptized as a Catholic REQUIRED Yes, Baptized as a Catholic No, please give me info on receiving Baptism No, not Baptized as a Catholic Please fill out this field.
- Baptism Date REQUIRED Please fill out this field. Please enter valid data.
- First Holy Communion Date REQUIRED Please fill out this field. Please enter valid data.
- Confirmation Date REQUIRED Please fill out this field. Please enter valid data.
- Years of Catechesis Since First Holy Communion REQUIRED Please fill out this field.
- MIDDLE SCHOOL ONLY: Playing Sports in the Parochial League Yes, I understand my student must attend 75% of classes to maintain league eligibility. No, BUT my student is interested in playing in the parochial league. No, my student is not playing in the parochial league.
3. PARTICIPANT PERMISSION OF GUARDIAN
- Student Name REQUIRED Please fill out this field. Please enter valid data.
- I/We, the parent(s)/guardian(s) of the student listed above, request that he/she be allowed to participate in all events related to the Saltire program described above, and hereby give my/our permission for such participation.
- For the event participation statement: I agree. I do NOT agree.
- I/We give my/our permission to the sponsoring Diocese/Parish/School/Organization to take photographs, video or digital images of Participant during any events for future promotional purposes.
- For the photo statement: I agree. I do NOT agree.
4. CONSENT FOR DISCLOSURE TO INDIVIDUAL INVOLVED IN THE CARE AND TREATEMENT OF PARTICIPANT
- For the duration of the Event, I/We grant to the Diocese/Parish/School/Organization and its agents the following powers, to be used for the benefit of and on behalf of Participant:
  
  A. to receive any and all individually identifiable health information about the past, present and future medical condition of Participant, including, but not limited to, information necessary to the care and treatment of Participant and any illness or injury Participant may have sustained;
- Pertaining to Statement A: REQUIRED I agree I do NOT agree Please fill out this field.
- B. to authorize medical care for Participant, including, but not limited to, any and all treatment, examination, diagnosis or outpatient medical care rendered under the general or special supervision of and on the advice of any physician or surgeon licensed to practice medicine by the applicable licensing body in the state in which physician or surgeon practices.
- Pertaining to Statement B: REQUIRED I agree I do NOT agree Please fill out this field.
- C. I/We understand that the Diocese / Parish / School / Organization will not be liable to me/us or any or my/our successors in interest for any action taken or not taken in good faith.
  
  I/We understand that as parent(s) or legal guardian(s), I/we may be responsible for any liability which may result from the conduct of Participant at or during the weekly sessions or events. I/We understand that there is a risk of injury involved in any Youth Ministry activity.
  
  I/We hereby release the Diocese of Kansas City-St. Joseph, and its officers, agents, employees and volunteers, from any liability arising from claims of any kind or nature whatsoever in connection with Participant's participation in the weekly sessions and events.
- Pertaining to Statement C: REQUIRED I agree I do NOT agree Please fill out this field.
- If you do not agree with any of the above statements, please explain here. Please enter valid data.
5. TEXTING NOTIFICATIONS: High School Only
- The staff of St. Andrew's Saltire primarily communicates upcoming events and reminders through text notifications and emails to parents (information can also be found in the St. Andrew bulletin). If you would like your teen to receive group texts, your permission must be given to the Saltire staff (Youth Director, Assistant Youth Director and/or group leaders).
  
  According to Diocesan requirements, each text message to your teen is automatically texted to an email address ( saltireya@sataps.com
  or saltireym@sataps.com). These addresses are monitored by another adult other than the leader texting your teen.
- I/We give my/our permission to our high school teen to be contacted by the Youth Director, Assistant Youth Director and/or her/his small group leader with mostly group text reminders and updates regarding Saltire and activities related to the program.
- My teen can receive texts. I agree I do NOT agree
- Teen Cell Number (xxx) xxx-xxxx (or N/A) Please enter valid data.
- For parents wanting to be included in text notifications, please email your request to Carolyn at saltire@sataps.com. Please include the following information: "I would like to be included with group texts that are sent to my teen" or "I would like to receive all text communication to my teen, including quick replies to your teen's question." Please note that it is your responsibility to email Carolyn and indicate your exact preferences for texting notifications. If no preferences are indicated, you will only receive group text notifications.
FAMILY INFORMATION
- FAMILY LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Home Phone REQUIRED Please fill out this field. Please enter a phone number.
- Registered Parishioners of St. Andrew REQUIRED Yes, we have a recordable tithe at St. Andrew the Apostle. Yes, we are registered but we do NOT have a recordable tithe. We understand we will need to pay the non-parishioner fee. No Please fill out this field.
- Are Both Parents Catholic REQUIRED Yes, both parents are Catholic No, neither parent is Catholic No, only the mother is Catholic No, only the father is Catholic Please fill out this field.
FATHER INFORMATION
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone REQUIRED Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
MOTHER INFORMATION
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- If student is being confirmed, please list mother's maiden name: Please enter valid data.
- Cell Phone REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
How are you paying for Youth Ministry REQUIRED Payment Plan - Set up with Business Office Paying in Full - Submitting Online Paying in Full - Delivering Payment to Office Please fill out this field.
Comments
ELECTRONIC SIGNATURE
- The above student has permission to attend this event. By typing my signature below, I attest that I am the legal parent /guardian of the student. Type Signature Below REQUIRED Please fill out this field. Please enter valid data.

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