VBS Adult Volunteer Registration

Adult Participant/Chaperone 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.
Nickname (if different than First Name) Please enter valid data.
Gender REQUIRED Male Female Please fill out this field.
Age REQUIRED 18-20 21 or over Please fill out this field.
*Please Note: Young adults (18-20) may participate as part of a parish's adult team for training purposes, but may not be counted as an official chaperone for the official adult/youth ratio.*
T-Shirt Size (Adult Sizes) REQUIRED Please fill out this field.
Which areas of volunteering would you be interested in? (select all that apply) REQUIRED Co-Directing Decoration/Preparation Leader Small Group Leader Game Master Teaching Lessons/Activities Musician Decorating/Setting Up Small Tasks Please fill out this field.

Contact Information

Home 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.
Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Home Phone Number Maximum 20 characters
If none, leave blank
Please enter a phone number.
Email Address REQUIRED Please fill out this field. Please enter an email address.

Medical Information

The medical information below is requested but not required. It will be used only in the case of an emergency.
List any medical conditions, drug and non-food allergies, physical restrictions, recent surgeries, learning challenges, behavioral conditions, social concerns (depression, anxiety, etc.), or other items that will assist us in supporting the physical and mental health of you on this event.
Medical Information (see above)
Primary Care Physician Please enter valid data.
Physician's Phone Number Maximum 20 characters Please enter a phone number.

Insurance Information (If Applicable)

Insurance Carrier Please enter valid data.
Policy Number Please enter valid data.
Insurance ID Number Please enter valid data.

Food Allergy & Dietary Information

Food Allergies or Dietary Restrictions - Describe any food related allergy, reactions, seriousness & management.
Dietary Restriction: Vegetarian? Yes No
Dietary Restriction: Gluten Free? Yes No
Dietary Restriction: Peanut Allergy? Yes No
Please be sure to include additional detail for severe allergies and significant dietary restrictions.

Emergency Contact 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.
Relationship REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Below section for second emergency contact is optional.
First Name Please enter valid data.

Last Name Please enter valid data.
Relationship Please enter valid data.
Phone Number Maximum 20 characters Please enter a phone number.

Consents & Waivers

CONSENT TO PARTICIPATE AND LIABILITY RELEASE

In consideration for allowing me to participate in this activity, I assume all risks and hazards incidental to my participation in the Event, including transportation to and from the Event as well as exposure to or infection from diseases or viruses (such as COVID-19). In consideration for allowing me to participate in the described event, and on behalf of myself and my spouse, children, heirs, assigns, and personal representatives, I hereby release and agree to fully and unconditionally protect, indemnify, and defend the Parish, the Roman Catholic Diocese of Dallas, and their respective officers, agents, and employees (collectively, “Indemnitees”) and hold each Indemnitee harmless from and against any and all costs, expenses, attorney’s fees, claims damages, demands, suits, judgments, losses, or liability for injuries to property, injuries to persons, and from any other costs, expenses, attorney fees, claims, suits judgments, losses, or liabilities of any and every nature whatsoever arising in any manner, directly or indirectly, out of, in connection with, in the course of, or incidental to my participation in the Event, REGARDLESS OF CAUSE OR OF THE JOINT, COMPARATIVE OR CONCURRENT NEGLIGENCE OF THE INDEMNITEES. In the event any legal action is taken by either party against the other party to enforce any of the terms and conditions of this release, it is agreed that the unsuccessful party to such action shall pay to the prevailing party therein all reasonable court costs, attorneys’ fees, and expenses incurred by the prevailing party.

I HAVE READ THE CONSENT TO PARTICIPATE AND LIABILITY RELEASE AND I UNDERSTAND AND VOLUNTARILY AGREE TO THEIR PROVISIONS.
I Agree Please select this field.
AUDIO/VISUAL RECORDING & PHOTOGRAPHY CONSENT

On occasion, video recordings, audio recordings, photographic slides, and photographs are taken during parish and diocesan sponsored activities. These are utilized in newsletters, websites, event promotion, advertisements and other printed or electronic media. I hereby release and agree to fully and unconditionally protect, indemnify, and defend the organizing parish(es), the Roman Catholic Diocese of Dallas, and their respective officers, agents, and employees, (collectively, “Indemnitees”) and hold each Indemnitee harmless from and against any and all costs, expenses, attorney’s fees, claims damages, demands, suits, judgments, losses, or liability for injuries to property, injuries to persons and from any other costs, expenses, attorney fees, claims, suits judgments, losses, or liabilities of any and every nature whatsoever arising in any manner, directly or indirectly, out of, in connection with, in the course of, or incidental to the use or publication of any photographs, videos, or other images of me, REGARDLESS OF CAUSE OR OF THE JOINT, COMPARATIVE, OR CONCURRENT NEGLIGENCE OF THE INDEMNITEES.

I HAVE READ THE AUDIO/VISUAL RECORDING & PHOTOGRAPHY CONSENT AND I UNDERSTAND AND VOLUNTARILY AGREE TO THEIR PROVISIONS.
I Agree Please select this field.

CODE OF CONDUCT FOR ALL PARTICIPANTS

1. Every adult and youth will treat each other with respect, and conduct themselves in a manner that positively represents our Parish/Diocesan Community and the Catholic Church. Respect includes verbal exchanges, physical and psychological exchanges as well. Inappropriate displays of affection as well as any abuse of another person will not be tolerated.

2. Participants must attend all event activities. If provided, name badges must be worn at all times during the event.

3. All Adult and Youth participants must refrain from drinking and from the use of illegal drugs. The use of tobacco products by minors is prohibited and is strongly discouraged for adults. The purchase, possession, or consumption of beer, wine, or other alcoholic beverages, and the possession or use of illegal drugs by any individual will not be tolerated. Failure to comply with these rules will mean immediate dismissal from the event and could lead to legal ramifications. All participants, including those of legal drinking/smoking age, are expected to comply with these rules. Adults and youth will abide by all laws (vandalizing property damage, weapons, stealing, etc.) and will be held responsible for breaking these laws and for any damages. No weapon of any kind may be possessed by participants.

4. Adult leaders and chaperones have been given the authority to maintain safety and adherence to this Code of Conduct. Please give them your respect and cooperation.

5. Adults agree to abide by regulations outlined in this Code and at the event. If anyone fails to abide by the Code they may be asked to leave the event at their expense, with no right of reimbursement for any amount in connection therewith.

I HAVE READ THE ABOVE CODE OF CONDUCT AND I UNDERSTAND AND VOLUNTARILY AGREE TO THEIR PROVISIONS.
I Agree Please select this field.
Are you currently safe environment cleared with St. Michael's? REQUIRED Yes No Not Sure Please fill out this field.

Consent & Electronic Signature

This electronic signature must be completed by the adult participant or by a ministry leader inputting data from a paper consent form already completed by the adult and kept on file.
Name of Person Giving Consents and Agreeing to Consent Terms REQUIRED Please fill out this field. Please enter valid data.
Signer Type REQUIRED Self - over the age of 18 Ministry leader inputting data from a paper consent completed by a parent/guardian Please fill out this field.
To better authenticate a unique electronic signature, we ask you to enter the last four digits of your social security number OR driver’s license number OR other government issued ID#. If you do not have one of these numbers, ask your ministry leader for a paper registration form or an alternative PIN number.
Last Four Digits of Government Issued ID# REQUIRED Please fill out this field. Please enter valid data.
Type of ID REQUIRED Please fill out this field.

Full Name REQUIRED Please fill out this field. Please enter valid data.

Email Address REQUIRED Please fill out this field. Please enter an email address.

Signature REQUIRED Please fill out this field. Please enter valid data.

St. Michael -Garland 972-279-6581

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VBS Adult Volunteer Registration

vbs adult volunteer registration | 2026

vbs adult volunteer registration form

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