Life Teen Registration

Life Teen registration is now open for 2021-2022! The new school year begins June 1st, so if you plan on joining us for any of our summer events or bible studies please be sure to register. If you have questions contact Leigh Anne Butrum, lbutrum@judeatl.com.

Life Teen Registration 2021-2022

Student Name*
First Last
Student Email*
Student Cell
Student School*
Grade Level*
Which Sacraments has your child received? Check all that apply.*
- Baptism
- Holy Communion
- Confirmation
Student Address*
Street Address City ZIP Code
Parent Name*
First Last
Parent Primary Email*
Parent Phone*
Is your family registered at Saint Jude?*
Emergency Contact Name*
First Last
Emergency Contact Phone*
Does Student have special needs/allergies/health concerns?*
If Yes to above, please comment here
Permission to Contact Youth*
Saint Jude the Apostle Catholic Church follows the Archdiocese of Atlanta’s Social Media Policy and Guidelines for the Use of Social Networking Sites with Minors for contacting youth via social media. We may also use text messages, email, and parish-approved online/virtual platforms to contact youth. Per this policy and guidelines, parents must be made aware of how social media and electronic communications are being used. Parents must be told how to access the sites and be given the opportunity to be copied on all material sent to their children. After receiving written permission to communicate with young people, Archdiocesan employees should be encouraged to save copies of conversations whenever possible, especially those that concern the personal sharing of a teen or young adult. Please reference the policy and guidelines for more information. I hereby grant permission for Saint Jude the Apostle Catholic Church to contact my child for internal or external communications for one year via social media, email, text, and/or parish-approved online/virtual platforms. I understand I can request the same communications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can receive it in a printed form or by an email list).
- I give permission
- I do not give permission
Media Consent*
Saint Jude uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.

I hereby grant permission for Saint Jude the Apostle to use images and interviews of my child for internal or external communications for one year. My child may be photographed and/or interviewed for The Georgia Bulletin, and other media outlets. I understand content may be reprinted in The Georgia Bulletin or other media for public dissemination, including but not limited to film; video; television; radio; newspapers such as The Atlanta Journal and Constitution; websites. I release and relieve Saint Jude the Apostle and the Archdiocese of Atlanta from any responsibility or liability for any claims arising from the publication or reproduction of any photographs or interview in any news or other media. I waive any and all right to inspect or approve the finished images, video, or printed matter that may be used in conjunction with any image or video, or to approve the eventual use for which it may be applied. I understand that photographs, videos, and/or interviews are being done with the knowledge and approval of Saint Jude the Apostle and that a signed release form is required for every participating individual.

I agree to the media policy.
Medical Consent*
I understand that reasonable precautions will be taken to safeguard the health and well-being of the participants in our Life Teen program, and that I will be notified as soon as possible in the event of any emergency. In the case of sickness or an accident, I authorize and give consent to the Life Teen team, or other associated volunteers of the Life Teen program, to obtain medical care from a licensed physician, hospital, or medical clinic for my son /daughter in the event that myself or other legal guardian(s) cannot be reached. I hereby do release and forever discharge the Archdiocese of Atlanta and Saint Jude the Apostle Catholic Church from all manners of actions or claims, which I or my child(ren) shall or may have for any reason, arising from my child's attendance in the Life Teen program at Saint Jude the Apostle Catholic Church.
I agree to the medical policy.

Life Teen Registration 2021-2022

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