Event/Program: Santiago de Compostela Youth Ministry/Confirmation Location: Online - At Home/Santiago de Compostela Catholic Church (21682 Lake Forest Dr. Lake Forest, CA 92630)Date(s): October 2020 - May 31, 2021
I, parent (guardian) of First Name Last Name hereby give my permission for his/her participation in the above named activity. I agree to direct my child to cooperate and follow directions and instruction of parish, school or diocesan personnel responsible for this activity.As a condition of my child being all owed to do so, I hereby release and discharge the Diocese of Orange, its constituent organizations, including but not limited to The Roman Catholic Bishop of Orange, a Corporation Sole, and their officers, employees and volunteers from any and all claims for personal injuries or property damage that he/she may suffer as a result of his/her participation in the activity described above, whether or not such injuries or damage are caused by the negligence, active or passive, of any of the entities, individuals named or described above. I agree that in the event my child is injured as a result of his/her participation in the above names activities, including transportation to and from this activity, whether or not caused by the negligence, active or passive, of the parish, school, or diocesan youth activities program, or any of its agents or employees, recourse for the payment of any resulting hospital, medical, dental treatment or related costs and expenses will be first be had against any accident, hospital, medical or dental insurance, or any available benefit plan of mine or my spouse. I am not aware of any medical conditions of my child that would render it inappropriate for him/her to participate in any activity. I hereby give permission to the physician, nurse, dentist or licensed care staff selected by the supervisory personnel then present to render medical, dental or other appropriate treatment deemed necessary and appropriate by the physician, nurse, dentist or licensed care staff.
By clicking this link of the Diocese of Orange's website, https://www.rcbo.org/group/child-and-youth-protection/, you will have access to Safe Environment information and how we are responding to keep our youth in a healthy and safe environment.
From time to time, we take pictures and video of Confirmation events and gatherings. We would like to be able to use these photographs and videos for flyers, parish and diocesan publications, and the ministry website. To do this, we need both the student’s and the parent’s consent. We will not use the last names of any individual whose photos or videos are posted. If there are concerns about the pictures or videos posted on the website, please contact the youth ministry coordinator or webmaster and they will promptly be removed. I/We the parent(s) of this youth (name) First Name* Last Name*authorize and give full consent, without limitation or reservation, to Santiago de Compostela, to publish any photographs or videos in which the above named students and/or pictures or videos of his/her parents or grandparent(s) appears while participating in any program with the Santiago de Compostela ministry. There will be no compensation for use of any photographs at the time of publication or in the future.
Other Medical Information: * .
Date of Last Tetanus:. Date*
AUTHORIZATION AND CONSENT OF PARENT(S) OR LEGAL GUARDIAN(S): As custodian of the aforementioned minor, I First Name* Last Name* grant my authorization and consent for a designated adult to administer general first aid treatment for minor injuries or illnesses. If the injury or illness is severe, I authorize him or her to seek professional emergency personnel to attend, transport, and treat the minor and to issue consent for any medical care deemed advisable by a license medical professional or institution. I authorize the designated adult to exercise best judgment upon the advice of medical or emergency personnel.