Archdiocese of Denver/Risen Christ Catholic Parish Parental/Guardian Consent Form and Liability Waiver
Name of Minor (Participant) 1
Your answer
Grade
Your answer
Date of Birth
MM
/
DD
/
YYYY
Name of Minor (Participant) 2 *
Your answer
Grade *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Name of Minor (Participant) 3 *
Your answer
Grade *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Home Address
Your answer
Home Phone
Your answer
Parent/Guardian 1 Name
Your answer
Parent/Guardian 1 Phone
Your answer
Parent/Guardian 2 Name
Your answer
Parent/Guardian 2 Phone
Your answer
Consent to Participate
This form MUST be signed by Parent or Legal Guardian.

I grant my child(ren) permission to participate in Risen Christ Catholic Parish's Angel Tree Gift Distribution at Annunciation Catholic School, 3536 S. Lafayette St., Denver, 80205, from 5:00 PM to 8:00 PM on Wednesday, December 13, 2017.

As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above-named minor child(ren).

I understand transportation will be provided by volunteer parents and/or a Risen Christ Catholic Parish employee.

I further agree to defend, indemnify, and hold harmless Risen Christ Catholic Parish and the Archdiocese of Denver as well as any of its affiliated agencies and their respective agents, directors, officers, employees, and volunteers from any and all claims or demands made for damage, loss, illness, or injury to the above-named participant(s).

I agree to the above:
Date
MM
/
DD
/
YYYY
By checking "I agree" and typing your name below, you agree this is your electronic and legally binding signature.
Your answer
Please provide any allergy, medical, or other concerns about which we should be aware:
Your answer
Photographic, Promotional, and Social Media Release
I hereby grant consent and release to Risen Christ Catholic Parish to use my child(ren)'s likeness, whether in still, motion pictures, audio and video tape; my child's photograph and/or reproductions of him/her including voice (which includes commentary, remarks, and/or recordings); features, without name, for promotional purposes involving Risen Christ Catholic Parish Youth Ministry and Religious Education, for news and/or feature stories for Risen Christ Catholic Parish publications or The Denver Catholic or other media (which includes Internet, social media, print, radio, television), except for the endorsement of any commercial products.

These items may be used without limitation or reservation of any fee.

Minors cannot consent to media interviews nor waive their privacy right. These decisions must be made by parents/guardians; therefore, this release form must be signed by parents/guardians when the participant is a minor.

Names of child(ren) being given consent:
Your answer
Parent/Guardian Signature
Your answer
Date
MM
/
DD
/
YYYY
By checking "I agree" and typing your name above, you agree this is your electronic and legally binding signature:
Consent for Emergency Medical Treatment
In exchange for participation of my child(ren)'s participation in Risen Christ Catholic Parish youth activities, I agree to the following:

I authorize the Designated Supervisor(s) and/or volunteers to authorize and consent to any medical care for my child that he or she reasonably believes necessary, including, but not limited to, hospitalization or surgery. We agree to pay any expenses related to such medical care. We understand and acknowledge that the Designated Supervisor(s) will attempt to obtain our permission by telephone before authorizing or consenting to any medical care for my child if time and conditions permit.

I understand and acknowledge that any medical expenses related to illness or injury to my child are not covered by any insurance program maintained by Risen Christ Catholic Parish or the Archdiocese of Denver, and that I am responsible for such expenses.

I, individually, and in my capacity as parent/guardian acting on my own behalf and on behalf of my child, release Risen Christ Catholic Parish and the Archdiocese of Denver, and all of its affiliated agencies, schools, and their respective priests, religious men and women, deacons, teachers, principals, agents, employees, and volunteers, from all demands, claims, or liability, in law or in equity, which has arisen or may arise, for any damage, loss, illness, or injury to my child, including but not limited to claims arising out of allergic reactions, and waive any such demands, claims, or liability.

Name of child(ren) being given consent:
Your answer
Parent/Guardian Signature
Your answer
Date
MM
/
DD
/
YYYY
By checking "I agree" and typing your name above, you agree this is your electronic and legally binding signature.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms