Parent Information:
Relative or friend to contact if unable to reach parent/guardian in the event of emergency:
PARENTAL CONSENT FORM
I/We the parents(s)/guardian(s) do hereby give my/our permission and approval for my/our son/daughter/guardianship to participate in the Catholic Scout Day and/or Marian Medal Retreat, on August 5, 2017, at Scared Heart Catholic Church, 539 E. Pearl Street, La Grange, TX 78945.
I/We do hereby, for myself, my heirs, executors, and administrators, waive, release, absolve, indemnify and agree to hold harmless any and all adults who chaperone any events related to this event, other participants, the Catholic Diocese of Austin and the Committee on Scouting, Sacred Heart Catholic Church, the retreat staff and any of the above names parties’ representatives, successors, supervisors, sponsors, and/or organizers, for any injuries in connection with any outings/event(s) named above, provided that said injuries are not the result of gross, willful negligence.
I/We likewise release from liability any person(s), airline, bus company, or other transportation service, transporting my child, in a privately owned and/or leased vehicle, to and from any activities connected with the above named event(s), with the exception of gross negligence due to either fully, or in part, to mechanical failure and/or operator error.
I/We also give permission to seek any emergency care should my child be involved in any accident or be injured in any way during such events named above. I/We understand that in any such instance, all attempts will be made to contact the parent/guardian. In the event that I/We cannot be contacted, I/We hereby give permission to the attending physician to hospitalize, secure treatment for, and to order injection, anesthesia, and/or surgery for my child as deemed medically necessary. Unless otherwise instructed, it is permissible that my/our son/daughter/guardianship be given aspirin/pain medication/cold medicine by either medical personnel or other adults responsible during this event.
I/We also agree that I/We am legally responsible for all/any personal actions taken by my/our child/guardianship during this event, and agree to be financially responsible for any/all damages, legal fees, and other costs incurred as a result of the actions/behavior of my child/guardianship.
Furthermore, I/We agree that if the above named child’s behavior is inappropriate, unsafe and/or detrimental to the group, I/We will be contacted immediately to secure means of removing my/our child/guardianship from the event premises. I/We understand that any financial costs incurred as a result of my/our child/guardianship being sent home are my/our responsibility.
Additionally, I/We give permission for my/our son/daughter/guardianship to be photographed during activities associated with the above-mentioned event. I/We understand that said photos/videos may be used for future publicity within the parish, Diocese, Scout Troop and/or Catholic Church.
YOUTH AGREEMENT
In agreeing to the above line, I agree to abide by any/all policies and rules established for this event/activity, including but not limited to the specific rules set forth by the Diocese and the Scouting Committee. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent’s expense.
Basic rules/expectations include, but are not limited to, the following: Respect for all adult leaders, peers, and all property; NO illegal drugs, alcohol, underage smoking, firearms, explosives, or other illegal substances; males and females are to remain in separate sleeping spaces at all times; no inappropriate physical/sexual activity; appropriate attire is to be worn at all times. Other guidelines may be set forth accordingly by the adult chaperones present for the event(s).
