Emergency Medical Authorization Form

/Emergency Medical Authorization Form
Emergency Medical Authorization Form2019-03-27T15:35:58-04:00

Emergency Medical Authorization Form

NOTE: You must complete this form for EACH child registered in VBS.

Download and Print:  Emergency Medical Authorization Form 2018-2019

Emergency Medical Authorization Form

  • Enter "NONE" if not applicable.
  • Enter "NONE" if not applicable.
  • Enter "NONE" if not applicable.
  • Emergency Contacts

  • Consent

  • Please read closely before you choose.
  • By typing your name you are signing authorization form.
  • Photo Release and Authorization

    This RELEASE AND AUTHORIZATION acknowledges that all photographic negatives, positives, and prints shall constitute the property of St. Ambrose and may be used by St. Ambrose for any purpose determined at its discretion without further notice or any compensation to me or my daughter/son.
    I (we) the parent(s) and/or guardian(s) of my minor child(ren) do hereby consent and authorize the release, publication, dissemination, distribution, use and/or reproduction of any and all photographs taken of my (our) daughter/son during her/his participation at St. Ambrose programs by an employee, agent or representative of St. Ambrose or independent contractor.
  • By typing your name you are signing authorization form.

Parish Registration

We welcome you to join our parish community, to grow in a family of faith, and experience the wonderful things at Saint Ambrose Parish!

Register

Eucharistic Adoration

Come and spend some time in prayer during Eucharistic Adoration as we “watch and wait," remaining “silent” in His loving Presence.

Sign-Up