St. Francis Xavier Consent 2022/2023

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Below please complete the forms giving permission for your child to participate in our PSR/Edge/Sunday School activities for the time period August 1, 2022, to July 31, 2023.

Email *

First Name *

Last Name *

Date of Birth *

YYYY

Emergency Cell number *

Mother's name *

Mother's cell *

Father's name *

Father's cell *

I give my permission for the above named Individual to attend the activities listed above and agree to all terms and conditions stated above. *

Yes

Required

By typing my name below, which shall constitute my electronic signature, I acknowledge that I am the legally duly authorized parent, legal guardian, or caregiver of the Individual(s) named in this form and have the authority to sign this document and act on his/her or their behalf. I agree that my electronic signature is intended to authenticate this writing and to have the same force and effect as my manual signature. My signature below indicates that I have read, understood, and freely signed this agreement. I further certify that I am at least eighteen years of age and that I am otherwise legally competent to sign this agreement. I further understand that the terms of this agreement are legally binding. This agreement shall be construed and enforced in accordance with the laws of the State of Ohio, and I consent to the jurisdiction of said state. If any portion of this agreement is held invalid, it is agreed that the balance shall continue in full legal force and effect. *

Today's date *

YYYY

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