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RELEASE OF CLAIMS   IMMACULATE CONCEPTION  CHURCH MADISON OHIO(the Parish)
In exchange for and in consideration of the opportunity for my minor child to participate in the  Catholic Heart Work Camp from 6/15-6/20/2025 in Montague MI and going to FunTyme in Grand Ledge, MI (the “Activity”) sponsored by Immaculate Conception Church, Madison Ohio

  •  I hereby agree to the following:

  • I understand the scope and nature of the Activity, including that my child will be driven between Immaculate Conception Church, Madison, OH to Montague, Michigan by car on June 15th  and to Fun Tyme in Grand Ledge , MI on June 20th  by car and will be driven back to ICC Madison from Montague, MI at the end of trip.


 
I recognize, as with any activity, the possibility and risk of injury associated with my child’s participation in the Activity and that such injury can include, but is not limited to, serious bodily injury, permanent disability, paralysis, and death.
I and my spouse assume, for ourselves and on behalf of our minor child, all risks in connection with my child’s participation in the Activity.
To the fullest extent allowed by law, I, on behalf of myself, my spouse, my minor child, as well as our respective heirs and assigns, executors, all other legal representatives and any others claiming through us or on behalf of us, hereby agree to release, discharge, hold harmless and indemnify Immaculate Conception Church, Madison, the Roman Catholic Diocese of Cleveland, the Bishop of the Roman Catholic Diocese of Cleveland, and Catholic Charities Corporation (Catholic Charities, Diocese of Cleveland), as well as their respective clergy, officers, employees, agents, representatives, attorneys, sponsors, and volunteers from and against all claims, judgments, liability (of any nature or extent) which in any way arise out of or relate to my child’s participation in the Activity, whether foreseen or unforeseen, regardless of the cause (including, but not limited to, the negligence of any person).

I understand that it is my responsibility to carry appropriate medical insurance for my child and that such is not the responsibility of any other person or party, including, without limitation, the Parish, or the Diocese of Cleveland.

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I have carefully read and understand and accept the terms and conditions stated herein and I have signed this agreement of my own free will. For Online Forms Add: By typing my name below, which shall constitute my electronic signature, I agree that my electronic signature is intended to authenticate this writing and to have the same force and effect as my manual signature.
Name of Minor Child:

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Name of Driver: *
Parent/s Signature:

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Date: *
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