ECYD Weekend 2: The ECYD Mentor

Join us for a weekend of fellowship and training as we delve into the ECYD charism and the role of team leaders and adult mentors!

WHEN: March 5 - Friday, 6pm-9pm (Intro, Dinner, & Social
  March 6 - Saturday, 9am-6pm (ECYD Formation & Dynamics)
COST: $60.00 per participant
WHO: Adults involved in our ECYD youth ministry
FRI-MARCH 5: 2225 Stoney Point Farm Rd, Cumming, GA 30041
SAT-MARCH 6: Queen Building, 8th Floor, 5 Concourse Parkway, Atlanta, GA 30328 
CONTACT: Fr. Patrick O’Loughlin, LC at poloughlin@legionaries.org
Registration
Qty
Description
Amount
Total

$60.00
$60.00
per participant
 
Administrative Code:
---
Total: $60.00
Future Commitment: $0.00
Participant Information
if applicable
Emergency Contact Information
RELEASE / WAIVER / INDEMNIFICATION
FOR ACTIVITIES - 18 YRS & OLDER
2020-21 – RC ACTIVITIES, INC.
1. NATURE AND DURATION OF ACTIVITIES: Talks, formation, and discussion; March 5 - 6, 2021
2. ACTIVITY SUPERVISORS: Fr. Patrick O’Loughlin, LC; Natalia Santos, CRC
3. TRANSPORTATION: Not applicable. Transportation is not provided. Participants are responsible for arranging their own transportation to and from the event, as the company does not provide transportation.
4. REQUIREMENTS: The participant named above/here is in good health and has no physical or medical limitations that would cause the activities as described above to be detrimental or dangerous to the participant. Specific allergies and medical problems should be indicated in the appropriate fields above.
5. CONSENT: The participant named above/here certifies that he/she is above the age of majority and hereby consents to participate in the activities described above, and specifically requests that he/she be allowed to participate in those activities.
6. AUTHORIZATION: The participant named above/here hereby authorizes RC Activities, Inc. to use the image and likeness of him/her in photograph or video form whether taken by or commissioned by RC Activities, Inc. in its promotional materials and for its promotional purposes associated with its nonprofit activities. This authorization shall extend to use of his/her image and likeness on website of RC Activities, Inc. or its successor in operation or affiliated organization(s) upon written consent of RC Activities, Inc. The participant named above/here understands that this authorization shall survive the end of his/her participation in the activities referenced on this form.
7. INSURANCE: The participant named above/here understands that RC Activities, Inc. does not carry any insurance relative to the activities or for any injury that may occur to him/her. The participant named above/here represents that he/she is (a) covered by insurance through his/her own insurance carrier; or (b) that he/she is personally financially responsible for any and all medical costs incurred as a result of injury.
8. EMERGENCIES: If the participant named above/here requires any emergency medical procedures or treatments during the activities, he/she consents to the activity supervisor(s) taking, arranging for or consenting to such procedures or treatments in the discretion of the activity supervisor(s). For purposes of such procedures and treatments, the above-named participant’s blood type allergies or other medical problems (if any) are listed above.
9. EMERGENCY CONTACTS: In the event of a medical or other emergency, The participant named above/here authorizes the activity supervisor(s) to contact the emergency contacts listed on the registration form.
10. RELEASE AND INDEMNIFICATION: I release and waive, and further agree to indemnify, hold harmless or reimburse RC Activities, Inc. and Consolidated Catholic Administrative Services, Inc., the individual members, agents, directors, officers, employees, volunteers and representatives thereof, as well as activity supervisors, from and against, any claim which I, any parent or guardian, any sibling, or any other person, firm or corporation may have or claim to have, known or unknown, directly or indirectly, for any losses (including attorneys’ fees incurred by RC Activities, Inc. and Consolidated Catholic Administrative Services, Inc., or any of its individual employees, agents, volunteers, etc. in enforcing this indemnity provision) without limitation in time or amount, damages or injuries arising out of, during, or in connection with my participation in the activities, the travel to and there from, and the rendering of emergency medical procedures or treatment, if any. I understand that this release and indemnification shall survive the end of my participation in the activities referenced on this form and shall have no limitation in time or amount.
ASSUMPTION OF COVID-19 RISK AND WAIVER OF LIABILITY

I acknowledge [for myself and/or my child(ren)] the highly contagious nature of COVID-19, as well as its potential to cause infection, illness, injury, permanent disability, and death. I voluntarily accept and assume the risk that I may be exposed to or infected by COVID-19 by visiting/participating/attending the above named event operated by RC Activities, Inc. I further accept [for myself and/or my child(ren)] and assume the risk that such exposure or infection may result in my [my child(ren)] personal injury, illness, permanent disability, and/or death. RC Activities, Inc. cannot prevent you [for yourself and/or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while visiting/participating/attending the above named event It is not possible to prevent against the presence of the disease. Therefore, if you [for yourself and/or your child(ren)] choose to visit/participate/attend the above named event you [for yourself and/or your child(ren) may be exposing yourself [your child(ren)] to and/or increasing your risk of contracting or spreading COVID-19.

I understand that the risk of becoming exposed to or infected by COVID-19 may be increased as a result of the actions, omissions, and/or negligence of RC Activities, Inc., including its independent contractors, agents, vendors, guests, and employees. I voluntarily assume [for myself and or my child(ren)] all of the risks of COVID-19 and of COVID-19 exposure and accept sole responsibility for any harm to me [my child(ren)] (including, but not limited to, personal injury, illness, permanent disability, and death). I understand that the risk of becoming exposed to or infected by COVID-19 may be increased as a result of the actions, omissions, and/or negligence of RC Activities, Inc., including its independent contractors, agents, vendors, guests, and employees. I voluntarily assume [for myself and or my child(ren)] all of the risks of COVID-19 and of COVID-19 exposure and accept sole responsibility for any harm to me [my child(ren)] (including, but not limited to, personal injury, illness, permanent disability, and death).

In consideration of RC Activities, Inc. allowing me onto its premises/visiting/participating/attending the above named event I also, on behalf of myself [my child(ren)] and my successors and representatives, waive, release, and forever discharge RC Activities, Inc. , its agents, employees, officers, directors, contractors, customers, successors, and assigns from any and all claims and causes of action of any kind or nature which are in any way related, directly or indirectly, to COVID-19, which I may have or that hereafter may accrue, including any such claims or causes of action caused in whole or in part by the negligence of RC Activities, Inc., its agents, employees, officers, directors, contractors, customers, successors, and assigns. I [for myself and/or my child(ren)] further agree that I will not bring any claim or cause of action against RC Activities, Inc., its agents, employees, officers, directors, contractors, customers, successors, and assigns related in any way, directly or indirectly, to COVID-19, and/or any associated personal injuries, illness, disability, or death.

I [for myself and/or my child(ren)] further agree to indemnify, defend, and hold harmless RC Activities, Inc., its agents, employees, officers, directors, contractors, customers, successors, and assigns from any claims or causes of action of any kind arising from my exposure to COVID-19 as a result of visiting/participating/attending the above named event provided by RC Activities, Inc.
ELECTRONIC SIGNATURE

I have read and understand the above permission form in its entirety, and also understand that it is a legal document and I agree and consent to all terms and conditions contained within.
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