General Permission Form for Youth Group
Release of all claims
In
consideration for being accepted by St. Bernards Parish for participation in
all youth group activities, including all activities on the property of St.
Bernards as well as any normal youth group activities off of the premises of
St. Bernards Church including dances, pizza parties, ball games, ice cream
parties, service projects, or any other normal outside activity, we (I), being
21 years of age or older do hereby release, forever discharge and agree to hold
harmless St. Bernards Church and the directors, staff and adult volunteers
thereof from any and all liability, claims or demands for personal injury,
sickness or the death, as well as property damage and expenses, of any nature
whatsoever which nay be incurred by the undersigned and the child-participant
that occur while said child is participating in the above said activities or
trips.
Furthermore, we (I) and on behalf of my
child-participant hereby assume all risk of personal injury, sickness, death,
damage and expense as a result of participation in recreation and work
activities involved therein.
The undersigned further hereby agree to
hold harmless and indemnify said church, its staff and volunteers, for any
liability sustained by said church as the result of the neglect, willful or
intentional acts of said participant, including expenses incurred attendant
thereto.
We (I) are the parent(s) or legal
guardian(s) of this participant, and hereby grant our (my) permission for him
(her) to participate fully in said trip, or activity, and hereby give our(my)
permission to Chad Taber or his representative to take said participant to a
doctor or hospital and hereby authorize medical treatment, including but not in
limitation of emergency surgery or medical treatment, and assume all the
responsibility of all medical bills, if any.
Further, should it become necessary for
the participant to return home due to medical or disciplinary reasons or
otherwise, we (I) hereby assume all transportation costs.
Name
of Participant ______________________________
Print
name of parent(s)____________________________ Phone #__________________
Signature
of parent(s)_________________________
__________________________
Emergency
contact_______________________________ Phone #__________________
I have
read and understand the forgoing and will abide by all of the rules and
direction of the adults in charge of given youth group activities.
Signature of participant____________________________