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I grant permission for the student listed above to participate in the above named activity and I warrant that my child is in good health. In consideration of my child’s participation, I agree to hold Divine Mercy Catholic Church and the Archdiocese of St. Paul & Minneapolis harmless from any and all claims resulting in my child’s participation in this event. I further agree to indemnify Divine Mercy Catholic Church and the Archdiocese of St. Paul & Minneapolis from any claims or law suits brought against Divine Mercy Catholic Church and the Archdiocese of St. Paul & Minneapolis by myself, my child or others, that arises out of any behavior by my child at the event/activity described above and for any harm my child incurs by reason of their participation in the above described event. I also agree to pay reasonable attorney’s fees or expenses incurred by Divine Mercy Catholic Church and the Archdiocese of St. Paul & Minneapolis.

USE OF IMAGE: I grant permission to Divine Mercy Catholic Church and the Archdiocese of St. Paul & Minneapolis to use and publish for advertising,  commercial or publicity purposes, likeness of my child, or for any other lawful purposes whatsoever, including photographic portraits, pictures, reproductions, made through any medium, including electronic media, and the undersigned parent/guardian does hereby release Divine Mercy Catholic Church and the Archdiocese of St. Paul & Minneapolis or anyone authorized by the with such use. This authorization and consent permits such use to associate my child’s name with the likeness for such purposes provided such use is consistent with the acceptable use policy for electronic communications and other policies.

EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I give permission to transport my child to a hospital for medical treatment. I wish to be advised prior to any further treatment by a doctor or hospital. In the event of any emergency, if you are unable to reach me at the above numbers please use the contact information below.

Medical Information

Do you allow your child to participate? *
Signature *
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Code of Conduct

Please remember you are representatives of Divine Mercy Catholic Church. We expect you will represent your parish, school and the Archdiocese well during this event. Recall that you are a witness to Christ to the press and others who will attend this gathering. We ask you to project an image of Christian charity and respect to everyone and to the property around you. We are confident you will display maturity, responsibility in leadership and character.
 
Thank you!
 
Participants are responsible for their actions. Each participant accepts the full responsibility for any damage or theft caused while attending this event. Leaders/Chaperones are expected to enforce the Code of Conduct and set an example for the participants. Please check all the boxes. *
Student Signature *
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Parent Signature *
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