Block 8 Off-Campus Extra-Curricular Activity Form
I hereby permit my child/ward ("Participant") to leave campus during Block 8 to attend an Off-Campus Extra-Curricular Activity for the remainder of the 2019-2020 school year. If I am the Participant and am 18 years of age or older, I make these representations for myself.

I will direct the Participant to follow all instructions and guidelines provided by Mater Dei High School faculty, staff and Activity personnel while traveling to the activity and during the activity. Additionally, I will direct the Participant to drive immediately and directly to the Off-Campus Extra-Curricular Activity.

In consideration for Mater Dei High School allowing the Participant to participate in the Activity, I agree not to sue and I hereby release, waive, discharge, hold harmless, indemnify, and defend Mater Dei High School and the Catholic Diocese of Orange, as well as their respective employees, personnel, staff, volunteers, agents, directors, affiliates, and representatives, from any and all liability, losses, damages, claims, actions, and causes of action of every nature, whether claimed by Participant, Participant's family, or any third party, for any and all known or unknown, foreseen or unforeseen, bodily or personal injuries, property damage, or other loss relating in any way to the Participant's involvement in the Activity, including but not limited to travel to and from the Activity.

I also understand that the Participant accepts full responsibility for his/her actions while traveling to the Activity and during the Activity, and will face disciplinary consequences for violating any Mater Dei High School disciplinary regulations or conduct standards as set forth here or in the Parent/Student Handbook.

I agree to allow my child/ward to participate in the Activity.

By signing below, I represent that I have read, understand, and agree to the terms outlines above. I understand that by signing this document, I am waiving certain legal rights, and do so voluntarily.
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Email *
Parent/Guardian Signature *
Participant Signature *
Participant's Sport, Club or Activity *
Medications and Dosages *
Severe Allergies *
Emergency Contact Name *
Emergency Contact Telephone Number *
A copy of your responses will be emailed to the address you provided.
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