St Vincent de Paul Walk for the Poor Online Waiver Form

NATIONAL FRIENDS OF THE POOR® WALK
Date: October 15, 2022 at 9:00 a.m.
Location:  Saint Patrick's Parish

*10 dollar donations are requested to support the Saint Vincent de Paul Society.
 
Medical Authorization, Indemnification and Waiver of Liability  
In consideration for being allowed to voluntarily participate in the above-referenced event, I hereby:
 
a.) Consent to receive medical treatment, which may be deemed advisable in the event of injury, accident or illness during this activity or event. This release, indemnification, and waiver shall be construed broadly to provide a release, indemnification, and waiver to the maximum extent permissible under applicable law;  

b.) Agree to defend, indemnify, and hold harmless the Parish and the Roman Catholic Archbishop of Boston, a Corporate Sole, and its agencies, officers, and employees from and against any and all claims of any nature including all costs, expense and attorneys’ fees, which in any manner result from actions during this activity or event; and
 
c.) Waive and release forever the Parish and the Roman Catholic Archbishop of Boston, a Corporate Sole, and its agencies, officers, and employees from any and all liability for death, disability, personal injury, property damages, property theft, or claims of any nature which may hereafter accrue as a direct or indirect result of the participation in the activity or event.
 

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Email *
First and Last name of  participant one *
First and Last name of participant two
First and Last name of participant three
First and Last name of participant four
First and Last name of participant five
Contact phone number *
Yes, I agree to the waiver and that I am 18 or older, or that I have the authority to register these participants and agree to the waiver for them. *
Please type name of person agreeing to wavier for those under 18.
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