RSVP for Youth Gathering

RSVP for the ADP Youth Gathering

All 6th-12th grade students and youth leaders are invited to join us for a fun evening of group games, good food, worship, and teaching.

Where: Christ Church Fox Chapel (410 Christ Church Lane, Pittsburgh, PA 15238)
When: Sunday, May 18, 2025, 5:00-8:00pm
Cost: free

Email Address *

I am registering *

my child

myself, a student 18 or older (as of the event date)

myself, a youth pastor/leader

First Name *

Last Name *

Child's First Name *

Last Name *

Birthdate * +

Grade *

Chronic conditions, environmental and/or medical allergies:

Add another

Child's First Name *

Last Name *

Birthdate * +

Grade *

Chronic conditions, environmental and/or medical allergies:

Add another

Child's First Name *

Last Name *

Birthdate * +

Grade *

Chronic conditions, environmental and/or medical allergies:

Add another

Child's First Name *

Last Name *

Birthdate * +

Grade *

Chronic conditions, environmental and/or medical allergies:

1st parent to call in case of emergency *

Relationship *

Phone *

2nd parent/emergency contact *

Relationship *

Phone *

Congregation *

Medical Information & Release

I, by my signature, give any and all Anglican Diocese of Pittsburgh (ADP) or Christ Church Fox Chapel (CCFC) staff and/or approved adult volunteers permission to treat my child/children (myself, if over 18) for minor injuries and if need be to provide for emergency medical care in the event that the above emergency contacts cannot be located immediately. I also agree that I will not hold the ADP, CCFC, or their representatives responsible for any accident or injury that may occur at any event organized by the ADP.

Doctor's Name *

Phone *

Insurance Provider *

Member ID(s) *

Media Release

During ADP events, participants may be recorded and/or photographed for use on our website, social media, and other promotional material. If you object to such publication, you must file a written objection at communications@adpgh.org in advance of the event. The ADP will not deliberately publish your/your child’s image if you have filed a written objection, and will make a reasonable effort to avoid publication by any third party.

Parent Signature *

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Signature *

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