| Medical Authorization: I/We understand that the Catholic Diocese of Dodge City assumes no responsibility for accidents that may occur in association with diocesan events and activities. I/We agree to use my/our personal insurance to cover any such incidents. I/We understand that, in the event medical intervention is needed, every attempt will be made to contact the person listed above. In the event these individuals cannot be reached, I/We hereby permit the physician or any other qualified medical staff selected by the event leader to hospitalize, secure medical treatment, and/or order injection, anesthesia, or surgery for Participant as deemed necessary.
Permission for Other Medical Matters: YES, in the event it comes to the attention of the diocesan and/or parish chaperones that I/my child complains of illness, I grant permission for non-prescription medication (such as Tylenol, lozenges, etc.) and other forms of First Aid to be given to the participant.
Waiver: I understand that the Catholic Diocese of Dodge City and its agents will take all reasonable safety precautions at all times during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree to indemnify and hold harmless the Catholic Diocese of Dodge City, its leaders, employees, and volunteer staff from any claim arising from or in connection with attending this event.
Participants Code of Behavior: I understand that I am personally responsible for reading and abiding by these policies and standards of behavior contained, including any revisions posted on the diocesan website: http://www.dcdiocese.org/safe-environment/policy-code-requirements · I agree to look for ways to serve others with a joyful attitude. · I am aware that my actions affect people other than just me. · I will respect the property of other participants. · I agree to stay within activity boundaries and in groups of 3 or more, and respect gender specific boundaries. · I will respect my group and myself by dressing modestly.
Photo Release: YES, I hereby authorize the Catholic Diocese of Dodge City, and its agents to utilize photographic and/or video images of me or my child by the Catholic Diocese of Dodge City. In giving my consent, I hereby indemnify and hold harmless the Catholic Diocese of Dodge City and it’s agents from any and all responsibility or liability. I understand that I will receive no compensation should any photograph and/or video of my child or me be used.
Parental Permission: I/We the parent(s)/guardian(s) of said Participant request that my/our child be allowed to participate in the listed activity, and do hereby grant permission for the child named above to participate in the same activity.
Transportation: I/We understand that we are responsible to get our child to the said event location. I/We understand that if our minor child drives themselves, they are not allowed to leave/drive additional minors during the activity/program. |
