Grades 6th, 7th & 8th

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MIDDLE SCHOOL RALLY Grades 6th, 7th & 8th Saturday March 9, 2019 8:30am to 8:30pm St.

00 FOR EVENT ($10.00 per child if two or more siblings) + (OPTIONAL $15.

1 MIDDLE SCHOOL RALLY Grades 6th, 7th & 8th Saturday March 9, :30am to 8:30pm St. Anthony School, Wailuku EARLY BIRD REGISTRATION forms and payment due Wednesday February 6, 2019 $15.00 FOR EVENT ($10.00 per child if two or more siblings) + (OPTIONAL $15.00 each for T-SHIRT) REGISTRATION AFTER FEBRUARY 6, 2019 to February 13, 2019 REGULAR FEE is $20.00 per child. ($15.00 if more than one sibling) Organized by the Maui Vicariate Youth and Young Adult Board

2 MAUI VICARIATE YOUTH MINISTRY PROJECT: MIDDLE SCHOOL RALLY FEARLESS TOO ST. ANTHONY SCHOOL AND CHURCH, Wailuku, MARCH 9, 2019 SUBJECT TO CHANGES tentative as of November 2018 COORDINATED BY STUDENT LEADERS FROM MAUI PARISHES, especially those who attended the 2017 and 2018 CLI (Christian Leadership Institute) 8:30 am - 9:00 am: Arrival and registration; name tags; prep for opening at THE QUAD (upper campus outdoor assembly area; bleacher seating) 9:00 am - 9:10 am: Passing to the FLEX LEARNING CENTER (general assembly site) 9:10 am - 10:10 am: Opening, Welcome, House rules, Code of Conduct, Explanation of Workshops, Mixers, followed by 15 mins 9:25 am 10:10 am PRAISE AND WORSHIP 45 mins 10:15 am 11:00 am Keynote Speaker: Mr. Malcolm Zara from 45 mins St. Michael s School & EPIC Ministry 11:00 am - 11:15 am: Small break 11:15 am - 11:20 am: Passing to Workshop as Assigned 11:20 am - 12:05 pm: Workshop #1 (upper campus as assigned) 40 mins 12:05 pm - 12:10 pm: Passing to the Quad 12:10 pm - 1:20 pm: Lunch; Cleanup 70 mins 1:20 pm - 1:25 pm: Passing to Workshop as Assigned 1:25 pm - 2:15 pm: Workshop #2 (upper campus as assigned) 40 mins 2:15 pm - 2:45 pm: BREAK - REFRESH (Icebreaker) 30 mins 2:45 pm - 2:50 pm: Passing to Workshop as Assigned 2:50 pm - 3:30 pm: Workshop #3 (upper campus as assigned) 40 mins 3:30 pm - 4:30 pm: Break: get ready for church; GROUP PHOTO (attire for Mass directed by Moderators; okay to remain in Rally attire (shorts/t-shirts; refer to Rally Dress Code) 4:30 pm: - EARLY Passing to Church for all Mass volunteers: hospitality, lectors, etc. 4:40 pm: - ALL report to church for Regular Weekend 5:00 pm MASS w/sa parish 6:05 pm - 6:15 pm: Passing to Quad; Get ready for Dinner 6:15 pm - 7:15 pm: Dinner; Cleanup 7:15 pm - 8:00 pm: Get your Jesus on! (Group mixers and energizers can also be used here) 8:15 pm - A hui hou farewell - LEAVE FOR HOME 8:40 pm - FINAL CLEANUP (small group leaders & moderators remain for thorough cleanup and return all classrooms and FLC to original position (desks, tables, chairs, etc.)

3 MEDICAL INFORMATION AND PARENTAL/GUARDIAN CONSENT FORM/LIABILITY WAIVER (Please print clearly.) Participant s name: Date of birth: Sex: M F Parent/Guardian s name: Home address: City: Zip Code: Mailing address (if different from above): City: Zip Code: Home phone: Cell phone: I, grant permission for my child, to participate Parent or guardian s name Child s name in this parish event that requires transportation to a location away from the parish site. This activity will take place under the guidance and direction of parish employees and/or volunteers from. Name of parish A brief description of the activity follows: Type of event: Date of event: Destination of event: Individual in charge: Estimated time of departure and return: Mode of transportation to and from event: As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor ( participant ). I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend, its officers, directors, employees and Name of Parish agents, and the Diocese of _Honolulu_, its employees and agents, chaperons, or representatives associated with the event, from any claim arising from or in connection with my child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors and agents, and the Diocese of _Honolulu_, its employees and agents and chaperons, or representative associated with the event for reasonable attorney s fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the parish or the Diocese of _Honolulu_.

4 MEDICAL MATTERS: I hereby warrant that to the best of my knowledge, my child is in good health and I assume all responsibility for the health of my child. (Of the following statements pertaining to medical matters, sign only those that are applicable.) Emergency Medical Treatment: In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, if you are unable to reach me at the above numbers, contact: Name: Relationship to participant: Phone: Family doctor: Phone: Family Health Plan Carrier: Policy #: Other Medical Treatment: In the event it comes to the attention of the parish, its officers, directors and agents, and the Diocese of _Honolulu_, chaperons, or representatives associated with the activity, that my child becomes ill with symptoms such as headache, vomiting, sore throat, fever, diarrhea, I want to be called collect (with phone charges reversed to myself). Medications: My child is taking medication at present. My child will bring all such medications necessary and such medications will be well-labeled. Names of medications and concise directions for seeing that the child takes such medications, including dosage and frequency of dosage, are as follows: No medication of any type, whether prescription or non-prescription, may be administered to my child unless the situation is life-threatening and emergency treatment is required. I hereby grant permission for non-prescription medication (i.e. non-aspirin products such as acetaminophen or ibuprofen, throat lozenges, cough syrup) to be given to my child, if deemed appropriate. Specific Medical Information: The parish will take reasonable care to see that the following information will be held in confidence. Allergic reactions (medications, foods, plants, insects, etc.): Immunizations: Date of last tetanus/diphtheria immunization: Does child have a medically prescribed diet? Does child have any physical limitations? Is child subject to chronic homesickness, emotional reactions to new situations, sleepwalking, bedwetting, fainting? Has child recently been exposed to contagious disease or conditions, such as mumps, measles, chicken pox, etc.? If so, list date and disease or condition: You should be aware of these special medical conditions of my child:

5 Maui Vicariate Youth Code of Conduct The following rules are set forth for the purpose of protecting all guests. Any violation of the following rules interferes with this event and may result in serious injury to you and others. Failure to comply with these rules will subject the offender(s) to removal from the premises without refund at the discretion of church personnel. In the event that a family member or someone needs to contact you in case of an emergency they may reach the Youth Minister or lead chaperone below: Name and phone contact of lead chaperone/moderator Youth participants will: Kalae Martin (808) Project an image of Christian consideration, sensitivity, and respect to everyone and to the property around them through language, dress, and behavior Refrain from inappropriate touching and verbal or physical harassment Respect other persons and/or property Refrain from actions that could result in injury and/or damage to property Keep their personal belongings with them at all times Not use clothing which contains obscene, foul, profane, pictures, symbols, phrases, etc. Attend all scheduled activities, arriving promptly, and staying for the entire event Not visit or gather in sleeping quarters with the opposite gender Maintain the spirit of the event Report problems of any kind to a trusted adult Not possess alcohol, illegal drugs or weapons of any kind Youth participants must be accompanied by their adult chaperone. The chaperone is solely responsible for supervision of their group. The parish/diocese does not assume any responsibility or liability for unattended youth. The Diocese of Honolulu and the host parish (parish name: _ST. ANTHONY CHURCH AND SCHOOL_) shall not be responsible for any loss or damage to vehicles, accessories, or the contents thereof caused by fire, theft, collision, water or other causes. Please remember that you are representing your parish and family by participating in this event. You are encouraged to take this responsibility seriously. If a problem of any kind occurs during this youth event, young people will immediately go to a trusted adult to discuss the matter.

6 PHOTOGRAPH AND VIDEO CONSENT FORM From time to time, pictures and video may be taken of youth ministry events and gatherings. We would like to be able to use these photographs and videos for flyers, parish and diocesan publications, and the ministry website. Written consent of both the student and parent/guardian is required. Names will not be posted unless written authorization is given by the student and parent/guardian, and then only first names will be used. If there are concerns about pictures or videos posted on the website, please contact the ministry coordinator or webmaster, and they will promptly be removed. I/We, the parent(s)/guardian(s) of this youth, authorize and give Youth s Name full consent, without limitation or reservation, to, to publish any Name of Parish/School photograph or video in which the above named student appears while participating in any program associated with ministry. There will be no compensation Name of Parish/School for use of any photograph or video at the time of publication or in the future. Student Signature: Parent/Guardian Signature: Parent/Guardian Signature: Date: Date: Date:

7 Field Trip Transportation Policy TRANSPORTATION POLICY Commercial carrier or contracted transportation is the most desirable method to be used for field trips and, whenever possible, this mode of transportation should be provided. The use of private passenger vehicles is discouraged and should be avoided if at all possible. If commercial carriers are used (i.e. commercial airlines, trains, or buses), no further information is required. However, if transportation is contracted, signed contracts should be executed with an appropriate hold harmless agreement protecting the parish/school and the Diocese. Also, contracted carriers should provide proof of insurance with minimum limits of liability of $2,000,000 CSL (Combined Single Limit). Leased Vehicles If a vehicle is leased, rented, or borrowed to transport participants to and from the event, appropriate insurance should be obtained. Coverage can be purchased through the rental company or your local agent. If auto coverage is provided through Catholic Mutual, contact should be made with your Member Services Representative. COVERAGE CANNOT BE AUTOMATICALLY ASSUMED FOR LEASED, RENTED, OR BORROWED VEHICLES. Private Passenger Vehicles If a private passenger vehicle must be used, then the following information must be supplied and this information must be certified by the driver in question. 1. The driver must be 21 years of age or older. 2. The driver must have a valid, non-probationary driver s license and no physical disability that could in any way impair his/her ability to drive the vehicle safely. 3. The vehicle must have a valid and current registration and valid and current license plates. 4. The vehicle must be insured for the following minimum limits: $100,000 per person/$300,000 per occurrence. A signed Driver Information Sheet for each driver must be obtained prior to the field trip. Each driver and/or chaperon should be given a copy of the approved itinerary including the route to be followed and a summary of his/her responsibilities. Distance Limitations (For non-contracted transportation) 1. Daily maximum miles driven should not exceed 500 miles per vehicle. 2. Maximum number of consecutive miles driven should not exceed 250 miles per driver without at least a 30 minute break.

Catholic Mutual CARES

Catholic Mutual CARES Field Trip Risk Management Information The purpose of the enclosed information is to provide sample forms and procedures to minimize the exposures created by participation in field