Dear Parents/Guardians of 7th, and 9th Graders,
Ghoul Evening! On Wednesday, October 26 we will be working on
a service project we call ‘Trick or Canning’, intended to introduce the 7
Principles of Catholic Social Justice Teaching (see back if you’d like to
quiz your child – it’ll be a real ‘treat’ for them!), collect non-perishable
food in order to feed the hungry, and have some fun in the process. We
will be driving to and walking the nearby neighborhoods to collect
food. We still need some help as far as chaperones, driving, sorting
food and for bringing &serving treats for the teens afterwards. Please
fill out the form below if you are able to assist. We need a permission
slip for each student and we are asking that each student bring a nonperishable food item or two if you’re able. Please return
permission forms by Sunday, October 23. No costume is
necessary – however there is a costume contest for leaders.
Yes! I would like to volunteer to help with the Trick or Canning Project! With so much to prepare we
will not phone you but will ask you to sign in when you arrive that night. Please be in the Great Hall
by 7PM – be patient as we get the teens organized and then we will put you to work.
Name:_____________________
Check the area you’d prefer to assist with:
___serve treats to teens after they return
___walk with a group (doesn’t have to be your teens’ class)
___drive group to a nearby neighborhood (fill out form attached)
___provide treats such as a package of cookies or bottle of pop.
___Provide a gift card/service for costume contest
___help organize/weigh food as it comes in (need lots for this!).
___Be a number cruncher and tally the pounds of food
___Help take food the following morning to food shelf on
Thursday, October 27 at 9:00AM (usually takes about an
hour)
Please detach and return this form to the office
c/o Denise Walsh by Sunday, Oct. 23
Thanks for your support and your generosity!
DRIVER INFORMATION SHEET
DRIVER
Name _______________________________________________ Date of Birth ________________________
Address _____________________________________________ Social Security # _____________________
_____________________________________________
Phone # ____________________________
Drivers License #______________________________________ Date of Expiration ____________________
VEHICLE TO BE USED
Name of Owner ______________________________________
Model of Vehicle _____________________
Address of Owner ____________________________________
Make of Vehicle _____________________
____________________________________
Year of Vehicle _____________________
License Plate # _______________________________________
Date of Expiration ____________________
If more than one vehicle is to be used, the aforementioned information must be provided for each vehicle.
INSURANCE INFORMATION
When using a privately-owned vehicle, the insurance coverage is the limit of the insurance policy covering that
specific vehicle.
Insurance Company _________________________________________________________________________
Policy # _____________________________________________ Date of Expiration ____________________
Liability Limits of Policy ____________________________________________________________________
Please note: the minimal, acceptable liability limit for privately-owned vehicles is $100,000/$300,000
CERTIFICATION
I certify that the information given on this form is true and correct to the best of my knowledge. I understand
that as a volunteer driver, I must be 21 years of age or older, possess a valid driver’s license, have the proper
and current license and vehicle registration, and have the required insurance coverage in effect on any vehicle
used to transport participants of the event.
_____________________________________________________ ____________________________________
Signature
Date
VOLUNTEER & EMPLOYEE DRIVERS
This information pertains to both volunteers and employees who use their personal vehicles on a mission for the
church/school.
Automobile insurance follows the vehicle; therefore, the volunteer’s auto liability insurance is primary.
Catholic Mutual has excess liability coverage only, which would come into effect only after all other liability
coverage is exhausted.
Under the No-Fault-Medical statute, if passengers are injured, the medical bills would go first to the passenger’s
own automobile coverage, or if the passenger is a minor, to the parent/guardian’s auto insurance. If the
passenger has no auto coverage, then the medical bills would go to the volunteer driver’s No-Fault medical
insurance. There is no medical coverage provided for volunteer drivers or passengers through the
Catholic Mutual Program.
-
Please be certain that your volunteer drivers have adequate insurance. The minimal acceptable liability
limit from privately owned vehicles in the State of Minnesota is $100,000/$300,000.
-
All drivers must be at least 21 years of age, even if they are parish/school employees.
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Drivers must have a valid driver’s license (non-probationary).
-
Drivers must fill out a Driver Information Sheet to be kept on file in the parish/school office.
In addition, drivers should not have any physical disabilities that could in any way impair their ability to drive
safely. The volunteer’s vehicle should be in good working order and have current registration and license
plates. It is advised, but not mandatory, that the volunteer carry collision and comprehensive coverage on their
vehicle as well, as the church/school cannot pay for damages to their vehicle if it is damaged in a collision or is
vandalized.
If a parish employee or volunteer, driving their personal vehicle on a mission for the church, does not have the
minimum amount of insurance coverage and is in an auto accident, that person will be held responsible for
paying any claims made due to the accident, up to the limit of financial responsibility allowed by law in
Minnesota.
Under no circumstances are 10-15 passenger vans to be used for school trips or to transport minors for parish
activities. Regardless of who owns the vehicle, how many passengers are in the vehicle, or how many seats are
installed in the vehicle, use of this van style is dangerous and strictly prohibited.
For further information, please contact your service office, (651) 290-1605.
Parental Consent Form and Indemnity Agreement for Saint Joseph’s Parish
Participant’s Name_____________________________________________________________
Birth Date____________Parent/Guardian’s Name____________________________________
Home Address:_______________________________City_________________Zip__________
Phone we can reach you during event: (___)_________________
Email:__________________________________
Parent Driving?________ *Please fill out driver waiver if yes
How many seats available in car?__________
Date/Type of Event: _ ____________________________Destination: ______________________
Individual In Charge: _ __________________
Estimated Time of Departure/Place: _______________Estimated Time of Return/Place: _ __________
Mode of Transportation to and from Event: ________________
I _________________________, grant permission for ________________________ (Parent or Guardian’s
Signature)
(Child’s Name)
to participate in the above activity and I warrant that my child is in good health. In consideration of my child’s
participation, I agree to indemnify the parish/school and the Archdiocese of St. Paul/Minneapolis by myself, my
child or others, that arises out of any behavior by my child at the event/activity described above. I also agree to
pay reasonable attorney’s fees or expenses incurred by the parish/school and Archdiocese in defense of such a
claim/law suit.
EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I give permission to transport my child
to a hospital for emergency medical treatment. I wish to be advised prior to any further treatment by a doctor or
hospital. In the event of an emergency, if you are unable to reach me at the above number,
contact:______________________________ at ___________________________
(Name)
(Phone Number)
OPTIONAL MEDICAL INFORMATION:Allergies, Medical or other concerns:
______________________________________________________________________________
Medication my child is taking at present:_______________________________________
__________________________________________________________________________
Name of Insurance Provider & Policy Number:______________________________
Family Doctor:_______________________ Phone Number:___________________
As a parent or guardian, I agree to all of the above stated considerations and conditions and
I hereby grant permission for non-prescription medication (such as non-aspirin products, i.e. acetaminophen or
ibuprofen, throat lozenges, cough syrup) to be given to my child, if deemed appropriate.
Signature:____________________________________________________Date: ________________