CONQUEST AND CHALLENGE: Mary Mother of God Parish,, Ontario, Canada.


1. NATURE AND DURATION OF ACTIVITIES: Primarily club meetings as well as formative recreational and
sporting activities. Conquest and Challenge MMOG  will inform parents/guardians of any other activities that may occur during the club year that fall outside this scope. All participants must follow Provincial Health Guidelines for COIVD-19 to ensure the safety of all.

2. ACTIVITY SUPERVISOR(S):  Adult Volunteer staff of Club/Program.

3. TRANSPORTATION: Not Applicable. Participants are responsible for securing their own transportation to and from camp/convention activities, as Conquest and Challenge MMOG does not provide transportation.

4. REQUIREMENTS: The child/children named in Section 3 is/are in good health and has/have no physical or medical limitations that would cause the activities as described above to be detrimental or dangerous to the child/children.

5. CONSENT:  I/We hereby consent to the above-named child's/children's participation in the activities described above, and specifically request that he be allowed to participate in those activities.  I/We warrant that I/We have full authority to legally consent to his participation in the activities described on this form, and all provisions contained herein.

6. AUTHORIZATION: I/We hereby authorize Conquest and Challenge MMMOG to use the image and likeness of my child in photograph or video form whether taken by or commissioned by Conquest and Challenge MMOG in its promotional materials and for its promotional purposes associated with its nonprofit activities. This authorization shall extend to use of my child’s image and likeness on website of Conquest and Challenge MMOG, or its successor in operation or affiliated organization(s) upon written  consent of Conquest and Challenge MMOG.  I/We understand that this authorization shall survive the end of my child’s/children’s participation in the activities referenced on this form.

7. INSURANCE: I/We understand that Conquest and Challenge MMOG does not carry any insurance relative to the activities or for any injury that may occur to child/children in .  I/We represent that the child/children is/are (a) covered by insurance through my own insurance carrier; or (b) that I/We am personally financially responsible for any and all medical costs incurred as a result of the child's/children’s injury.

8. EMERGENCIES: If the above-named child/children in Section 3 requires any emergency medical procedures or treatments during the activities, I/We consent 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, my child's/children's allergies or other medical problems are mentioned in Section 3 above.

9. RELEASE AND INDEMNIFICATION:  I/We release and waive, and further agree to indemnify, hold harmless or reimburse Mary Mother of God Parish, The Catholic Diocese of Hamilton and Legion of Christ Canada, 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 other parent or guardian, any sibling, the above-named child/children, 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 Conquest and Challenge MMOG and Legion of Christ Canada, 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 the child's/children’s participation in the activities, the travel to and there from, and the rendering of emergency medical procedures or treatment, if any. I/We understand that this release and indemnification shall survive the end of my child’s/children’s participation in the activities referenced on this form and shall have no limitation in time or amount.

10. If, in the event of a medical or other emergency, I/We am unable to be reached by telephone at my home or work telephone numbers listed in section 2 Contact Information, I/We authorize the activity supervisor(s) to attempt to contact me/us through the emergency contacts listed in section 2 Contact Information.