St. Christopher’s EYC Program Waiver
I give my informed consent and permission for my child to participate in St. Christopher’s EYC Program, over-night events, trash nights, lock-ins, retreats, mission trips, and all related activities.

I agree to have my child follow all Diocese and EYC guidelines and understand that any violation on my child’s part may result in their not being able to participate.

I hereby acknowledge that my child will be transported by staff or volunteers while participating in the St. Christopher’s EYC Program, and that such transportation is voluntary and at his/her own risk.

I release St. Christopher’s of all liability of injury, death, or other damages to me, my child, family, estate, heirs, or assigns that may result from his/her participation in the program, including but not limited to transportation, and hold harmless any St. Christopher’s, volunteer, staff, or other representatives, both collectively and individually, of any injury, physical or emotional, other than where gross negligence has been determined.

I hereby grant permission for St. Christopher’s EYC Program and staff to make contact with me and my child by all means. Staff may also make contact with my child on school premises for ongoing support of his/her participation in EYC.

I authorize St. Christopher’s EYC staff to obtain any needed information regarding my child from his/her school’s staff, including academic and behavioral records and conversations with teachers, counselors, family, doctors, and other administrative staff for up to date reporting on students overall progress.

I agree to allow St. Christopher’s EYC to use any photographic image of my child taken while participating in EYC. These images may be used in promotions or other related marketing materials.

Name of child *
First and last name
Your answer
Name of parent(s) or guardian(s) *
First and last name
Your answer
By submitting this form I agree to these conditions for my child's participation in EYC events
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