DIOCESE OF MAASIN

COMMISSION ON YOUTH
c/o St. Thomas Aquinas College
Corner Bagares and Conception Streets
Zone IV, Sogod, Southern Leyte Philippines

DYD 2019 REGISTRATION FORM

PARISH: _____________________________________ VICARIATE: _______________________________

TOTAL NUMBER OF DELEGATES: ______ MALE PARTICIPANTS: _______ FEMALE PARTICIPANTS: ______
HEAD OF THE DELEGATION: ________________________ CONTACT NUMBER: _____________________

Name of Delegates Nickname Gender Contact No. Shirt Size Ag Contact Person/Number
e

“Filipino Youth in Mission: Beloved. Gifted. Empowered”

 DIOCESE OF MAASIN
COMMISSION ON YOUTH
c/o St. Thomas Aquinas College
Corner Bagares and Conception Streets
Zone IV, Sogod, Southern Leyte Philippines

AUTHORIZATION AND WAIVER

I, _______________________________________, a citizen of the REPUBLIC OF THE PHILIPPINES, of legal

age, a resident of ___________________________________________________________, do hereby
depose and state that: I freely and voluntarily applied as a participant/delegation head to the DIOCESAN
YOUTH DAY 2019 (DYD2019) to be held on 2019 AUGUST 24-26 in the VICARIATE OF PANAON – ST.
IGNATIUS DE LOYOLA PARISH – LILOAN. I have fully understood the DYD2019 Rules/Responsibilities and
promise to faithfully adhere to all the guidelines and comply with all requirements, as well as to those to
be given by the Organizers. I confirm that all information herein are correct and accurate to the best of
my knowledge, and I authorize the DYD2019Liloan Organizers to use with discretion the information
contained herein as they deem necessary and legitimate; As delegation head, I commit that all our
delegates will attend all the DYD2019 events, from its commencement until conclusion; I shall exercise
extraordinary diligence, as that of a good father to his family, to prevent injury to myself and to my
fellow participants and to the Organizers and volunteers; I hereby waive, release and discharge the
DYD2019Liloan Organizers from any and all liabilities that can occur as a result of my/our actions during
this event.

I affix my signature below to certify that I have read this waiver and that I fully understand its content.

_____________________________ ___________________________ ______________________

Full Name Signature Date

ENDORSEMENT

I hereby approved and endorsed the participation of _____________ total number of delegates from
Parish of ____________________________________ to the Diocesan Youth Day 2019 on August 24-26,
2019 in St. Ignatius De Loyola Parish of Liloan, Southern Leyte.

_______________________________________
Parish Priest
(Printed name with signature)

_______________________
Date
“Filipino Youth in Mission: Beloved. Gifted. Empowered”
 DIOCESE OF MAASIN
COMMISSION ON YOUTH
c/o St. Thomas Aquinas College
Corner Bagares and Conception Streets
Zone IV, Sogod, Southern Leyte Philippines

“Filipino Youth in Mission: Beloved. Gifted. Empowered”