Form B - Youth Form

Diocese of Fort Worth and/or the Parish of Good Shepherd Catholic Community Consent to Participate and Consent for Emergency Medical Treatment


grant permission for 

to participate in the below described parish event. This activity will take place under the guidance and direction of parish employees and/or volunteers from the above named parish.

During this event, I give permission for the adult(s) named above in charge of the event to consent to emergency medical or surgical treatment for 

Insurance Update -- Has there been any change to personal information, insurance and/or medical information since I last filled out Form A for this child? *
Emergency Contact Information

Diocese of Fort Worth Code of Conduct,

expectations of all participants and dress code


The purpose of this Code of Conduct is to identify personal behavior that is consistent with the purpose and objectives of the Diocese of Fort Worth. The items within the Code are based upon performance and are designed to protect the welfare of all participants.

CODE OF CONDUCT OF ALL YOUTH PARTICIPANTS                                                                                             

  • Youth will respect themselves, other people, other people’s property, and church property.


  • Youth will participate and contribute in a positive way in all activities and obey the instructions of the youth ministry, adult volunteers, and staff.


  • During the event youth will show respect by not causing disruptions.


  • Harassment, intimidation or bullying will not be tolerated under any circumstances.


  • Youth will use language that reflects a Christian attitude. Youth will not use curse words or other foul language.


  • Youth will maintain a Christian witness to the dignity of each person: no tickling, wrestling, piggyback rides or inappropriate touching (which means: do not touch anyone anywhere that a bathing suit would cover). In addition, physical displays of affection such as kissing, full body hugs, sitting on laps, and lying or sleeping next to each other are inappropriate. Being isolated or alone with another student is not allowed.


  • Youth will wear modest clothing. No clothing that is sexually suggestive or spiritually degrading. T-shirts or other clothing with evil, vulgar, illegal, or inappropriate content will not be acceptable. In addition there should be: no midriffs, no low-cut tops, no spaghetti straps, no see through clothing, and no sagging pants to where underwear shows. Please do not wear short shorts. Shorts must follow the same guidelines as the school system.


  • Youth will stay with the group at all times during the event and will not leave early unless approval from a parent or guardian ahead of time or in person.


  • Youth will not possess any weapon of any kind (knife, gun, etc.) at any youth ministry activity at the church or event.


  • Youth will not use, possess or be under the influence of alcohol, tobacco, marijuana or any other illegal drugs at any youth ministry activity.


  • Youth will not engage in sexual intimacy or sexual harassment, and will not possess pornography at any youth ministry activity. Any illegal activity will prompt reporting to proper authorities depending upon the situation.


In the event the Code of Conduct is violated by a youth, proper diocesan protocols will be handled by the diocesan employee, pastor, youth minister or adult volunteer in charge. Failure to comply with the Code of Conduct will result in disciplinary action, up to and including removal from the event.


I have read and understand the above CODE OF CONDUCT, EXPECTATIONS OF ALL PARTICIPANTS and will comply.


This form “CONSENT TO PARTICIPATE and CONSENT FOR EMERGENCY MEDICAL TREATMENT” must be attached to the Parent/Guardian/Conservator Permission, Liability Waiver, and Medical Information (FORM A) for each event attended.  Forms A and B must travel to and from each trip away from the church.  Forms OA and OB are required for all Out of State events.

I am participating in *