Catholic Diocese of Evansville Event
Waiver and Release
I/We, the parent(s)/guardian(s) of the above-named
youth, hereby give my/our approval for his/her participation in the above
event. I/We assume all risks and hazards incidental to the conduct of the
activities and transportation to and from the event. I/We do further hereby
waive, release, absolve, indemnify, and hold harmless the Bishop of the
Catholic Diocese of Evansville, St John the Evangelist Parish, Fr. Chris
Forler, Pastor, and any of their respective affiliates, successors, agents,
employees, members, and representatives, adult sponsors, and other volunteers
involved in the activities and transportation associated with the event from
any and all claims, including claims of personal injury to my/our youth or
property damage, under any theory of law (including negligence, but not
reckless or intentional conduct) in any way resulting from or arising in
connection with the activities and/or transportation to and from the event.
It is understood and agreed that neither the Parish,
the Catholic Diocese of Evansville, any respective affiliate, successor, agent,
employee, member, representative, adult sponsor, nor other volunteer is the
insurer of my child’s health and safety while he/she is at youth functions,
engaged in supervised activities, including sports, or being transported in
association with the event. I/We understand it to be my/our obligation to
provide such insurance as I/we may desire to purchase to protect
myself/ourselves and my/our child against the costs of sickness or injury.
In case of emergency or serious illness, should the
above-named child require medical treatment, and neither a parent nor the
designated family physician can be contacted, consent is hereby granted for
such medical treatment as may be considered necessary in the opinion of the
attending physician. I understand that my signature relieves diocesan and/or
parish personnel of any and all liability related to the administration of any
prescribed medication listed on this registration form (including over-the-counter
drugs).
Further, I/we acknowledge having read, or been made
aware of the Diocesan Youth and/or Adult Codes of Conduct, the Diocesan Release
for Media Recording, and the Diocesan Off-site Transportation Policy, and I/we
agree to be bound by the terms and conditions set forth in those documents
(copies available via www.evdio.org/diocesan-forms-for-oyaya.html). I
acknowledge and understand that any action on behalf of my/our child/dependent
that is inconsistent with the Diocesan Code of Conduct may result in appropriate
disciplinary action as outlined in those documents.
I represent that I am at least 18 years of age, have
read and understand the foregoing statement, and am competent to execute this
agreement.
Parent/Guardian Printed Name:
I here by give my consent through this electronic signature:
