Volunteer Registration for Summer Camp

Volunteer Registration Form for Summer Camp

July 15-19, 2024---8:00am-2:00pm

Name of Adult Volunteer (18 or older)

Name of Teen Volunteer (14-17 years old)

Age as of July 18, 2023

If under 18, name of volunteer's parent/guardian

Volunteer's Address: Street

Volunteer's Address: City, State

Volunteer's Address: Zip

Volunteer's Cell Phone Number

Please enter a valid phone number.

Volunteer's Home Phone Number

Please enter a valid phone number.

If under 18, Cell Phone Number of volunteer's parent/guardian

Please enter a valid phone number.

Volunteer's Email

example@example.com

If under 18, Email of volunteer's parent/guardian

example@example.com

Select all the days when you can help:*

For Students: I am using this as a community service project

YesNo

For all parents, all guardians and all those 18 years of age or older:

I consent for any of my children listed below to participate in any activity or trip sponsored by the Archdiocese of Galveston-Houston or its affiliates* (collectively, "the Archdiocese" In case of medical need. I authorize the Archdiocese to arrange for medical or dental services for me and any of my children listed below. I agree that any such expense will be my obligation.

I, individually, and in my capacities as parent/guardian of my children: (name all children or participant's over the age of 18)

Waive. release. and indemnify the Archdiocese and its agents. directors. officers, employees. and volunteers (Collectively. the "Released Parties") from all claims or liability which have arisen or may arise from any diocesan activity or trip and which involves any damage, loss, or injury to me, my spouse, any of my children, my property, or the property of any of my children. In the same capacities, I promise not to sue any of the Released Parties for any such claims or liability. This waiver, release, indemnification, and promise not to sue does not apply to claims of criminal conduct or gross negligence.

This Activity release is revocable prospectively only by a written statement signed by me which bears the date that the revocation is delivered to the Archdiocese.

Signature of Parent/Guardian/Participant over 18

Date

Printed Name

Medical Insurance Company and Policy Number

Authorized Medications your child may be given (for volunteers under 18)

Family Physician's Name

Physician's Phone Number

*"Affiliates" includes all Archdiocesan parishes, missions, schools, and ministries and also the Institute of the Daughters of Mary Help of Christians (Salesian Sisters).

Photo/Video Release Form

I, (Type your name below)

Permission for photographs/videos of children in the program:

Give PermissionDo not give Permission

... for my photograph(s)/video(s) and/or those of my child(ren) to be used in program material produced by the Archdiocese of Galveston-Houston, Sacred Heart of Jesus Parish, Salesian Sisters publications, and Salesian Sisters web page/Facebook/Instagram.

I agree that for those photos/videos submitted to the Archdiocese of Galveston-Houston, the Archdiocese owns all rights of every kind in said photography.

Signature

Date

ACTIVITY RELEASE