Parental Consent
I hereby consent to participation by my child, above named, in the Middle School Retreat. I understand that
my child will be under the supervision of designated parish staff/adult volunteers on the stated date. I further
consent to the conditions stated in the event description regarding participation in this event, including the
method of transportation.
Further, I hereby authorize treatment for my child by a qualified and licensed physician of any condition
which, in the opinion of the physician, is deemed necessary and appropriate. This authority is granted only
after a reasonable effort has been made to reach me/my family. I further authorize the person who presents the
minor to sign the Acknowledgment of Receipt of Notice Privacy Rights that may be presented by the
physician or health care facility.
In consideration of my child being allowed to participate in the Assumption Middle School Retreat, I agree to
indemnify and hold harmless and defend the Parish, any and all affiliated organizations, their employees,
agents, and representatives, including volunteers and other drivers, from any and all claims arising from or
relating to my child’s participation in this event. This indemnification and hold harmless and defense
agreement does not apply to claims for intentional misconduct.
Finally, I hereby give permission do not grant permission for my child to be to photographed for
promotion (website, brochures, newsletters, etc.) of Parish programs.
