Youth Winter Lock In Registration and Permission

Youth Winter Lock In Saturday, Feb 1, 2020 4pm to Sunday, Feb 2, 2020 6am

I agree to review the Youth Code of Conduct with my child/ren participating in the event.

• Treat all other persons with respect and not cause any intentional harm (physically, emotionally, or spiritually) to any person in any way.
• Respect the property of others, including all program facilities and property.
• Follow all appropriate instructions of all personnel aiding in this event, including, but not limited to chaperones, support staff, transportation personnel and administration.
• Be on time for all check-ins and departure time.
• Not have in my possession any tobacco, alcohol or any controlled illegal substance.

I agree that if any of these terms are violated, the Parish/School can send the participant home at the participant/guardian’s expense.

By filling out this form, I am agreeing to all the permissions. 1) PARENTS: I GIVE MY PERMISSION FOR MY CHILD/REN to participate in the Church of St. Pius V Youth Winter Lock In at St. Pius V and GrandStay Hotel in Cannon Falls Saturday, February 1 to Sunday, February 2. I know that this is a "meet at" activity and no transportation will be provided. In consideration of my Child’s/ren’s participation, I agree to indemnify the Church of St. Pius V and the Archdiocese of St. Paul/Minneapolis from any claims or law suits brought against the parish/school/ Archdiocese of St. Paul/Minneapolis by myself, my child/ren or others, that arises out of any behavior by my child/ren at the Faith Formation and Youth Ministry classes/activities. I also agree to pay reasonable attorney’s fees or expenses incurred by the Church of St. Pius V and Archdiocese in defense of such a claim/law suit. 2) CONSENT AND PERMISSION TO TREAT MINOR In the event of an emergency, I give permission to transport my child/ren to a hospital for emergency medical treatment. I wish to be advised prior to any further treatment by a doctor or hospital. 3) PHOTOGRAPH/PRESS RELEASE I realize that photographs, videos, written extractions, and voice recordings of program participants may be taken during various activities for the purpose of illustrations, publications, and website. By signing this form, I hereby authorize and give full consent to Church of St. Pius V to publish and copyright all photographs, videos, written extractions, and voice recordings in which my child appears while participating in any Faith Formation/Youth Ministry activities. IN CASE OF INJURY OR ILLNESS YOUR OWN MEDICAL INSURANCE WOULD BE USED. MEDICAL INSURANCE PROVIDED BY THE PARISH OR THE ARCHDIOCESE IS LIMITED & IN EXCESS TO ANY OTHER VALID & COLLECTIBLE INSURANCE I/we the undersigned, have read all releases and understand all its terms and execute it voluntarily and with full knowledge of its significance. I/we the undersigned, have read all releases and understand all its terms and execute it voluntarily and with full knowledge of its significance. Print name.

Fee is $30 per youth. If unable to pay, please contact the office for assistance. You will be directed to a payment site after electronic signature.

 
 

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