Walk-a-Thon Permission Slip
All students participating in St. Finn Barr Catholic School's Annual Walk-a-Thon must submit a permission slip by Friday, November 4th, 2022.
Sign in to Google to save your progress. Learn more
Email *
Student Name: *
Name on the Walk-a-Thon bib: *
Home Address: *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian Name
Parent/Guardian Phone Number
Emergency Contact Name (other than parent/guardian to notify in case of emergency) *
Emergency Contact Phone Number (in case the Parent/Guardian cannot be reached) *
Student's Grade *
Untitled Title
I, the parent/guardian of the above named child, hereby give my permission for their participation in the Walk-a-Thon. I agree to direct my child to cooperate and conform to the directions and instructions of St. Finn Barr Catholic School. 

I agree to the extent permitted by law that in the event my child is injured as a result of their participation in the Walk-a-Thon recourse of payment of any resulting hospital, medical, or related costs and expenses will first be had against any accident, hospital or medical insurance, or any available benefit plan or mine. 

I am not aware of any medical condition of my child which would render it inappropriate for them to participate in any such activity. 

I hereby grant permission to the physician selected by the youth activities supervisory personnel then present to render medical treatment deemed necessary and appropriate by the physician. 

Further, I hereby waive any and all rights to, or compensation for, any photographs, videotapes, motion pictures, or recordings, or any other record of this event or activity may be made by the Archdiocese or San Francisco and St. Finn Barr Catholic School.
By typing my name below, I acknowledge that I have read the above agreement and grant permission for the student named above to participate in the St. Finn Barr Catholic School Walk-a-Thon on Saturday, November 12th, 2022. 

Clear form
Never submit passwords through Google Forms.
This form was created inside of St Finn Barr School. Report Abuse