1. I, the custodial parent/legal guardian of * * (the "Child") give permission to participate in the activity described on the Activity Information Form for Kenosis and/or Altar Guild and release from all liability, indemnify, and hold harmless St. Catherine of Siena Parish and School (“Parish and School”), the Diocese of Covington (the “Diocese”), the Bishop of Covington (the “Bishop”), both individually and as trustee for the Diocese, all parishes and schools within the Diocese, and all of their agents, representatives, volunteers, and employees from any and all liability, claims, judgments, damages, costs and expenses, including attorneys’ fees, arising out of any injury, illness, infectious and/or communicable disease (such as MRSA, influenza, or COVID-19), or death, (including any injury, illness, infectious and/or communicable disease, or death caused by the negligence of Parish and School, the Bishop, the Diocese, any parish or school within the Diocese, or any of their agents, representatives, volunteers, or employees) incurred by my Child while participating in the Activity, traveling to or from the Activity, or while using the facilities and equipment of the Parish and School. I further agree not to bring or prosecute or allow to be brought or prosecuted (including, but not limited to, prosecution through subrogation) in my name, or on behalf of my Child, any claims, lawsuits, or actions against Parish and School, the Bishop, the Diocese, all parishes and schools within the Diocese, or their agents, representatives, volunteers, and employees.
2. I understand that my Child’s participation in the Activity is purely voluntary and is a privilege and not a right, and that my Child, and I on behalf of my Child, agree to my Child’s participation in the Activity in spite of the risks of injury, illness, infectious and/or communicable disease (such as MRSA, influenza, or COVID-19), and death. I agree that if my Child has underlying health concerns which may place him/her at greater risk of contracting COVID-19 or that would possibly increase the severity of illness if COVID-19 is contracted, then my Child and I will consult with a health care
professional before participating in the Activity.
3. I agree to instruct my Child to cooperate with the agents of Parish and School and/or the Diocese who are in charge of the Activity.
4. I authorize the agents of Parish and School and/or the Diocese who are acting as leaders of the Activity to seek medical treatment for my Child in the event of any injury, illness, or medical emergency during the Activity or related travel. I understand that the agents of Parish and School and/or the Diocese will make a reasonable attempt to contact me as soon as possible in the event of a medical emergency involving my Child.
5. Please indicate. I * that Parish and School and/or the Diocese may use my Child’s portrait or
photograph for promotional purposes, website, and office functions.
6. Please indicate. I * that Parish and School and/or the Diocese may use social media and technology to communicate with my Child regarding parish/school related ministry activities.
7. This Permission, Release, and Authorization is intended to be as broad and inclusive as permitted by the law of the State of Kentucky, and if any portion hereof is declared invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This Permission, Release, and Authorization shall be construed in accordance with the laws of the State of Kentucky, excluding, and irrespective of, any choice of law principles to the contrary.
8. Parish and School, the Diocese, the Bishop and their agents, employees, and volunteers shall have no liability whatsoever in the event the Activity is canceled due, in whole or in part, to any present or future pandemic, epidemic, widespread disease or illness, public health concern, or circumstances arising therefrom, or from actions taken by any governmental or municipal authority to prevent, avoid, or mitigate the impacts thereof.
ACTIVITY INFORMATION
Starting Date: AUGUST 20, 2023 (Kenosis), FEBRUARY 21, 2024 (Altar Guild)
Ending Date: MAY 19, 2023 (Kenosis, MAY 7, 2024 (Altar Guild)
Registration Fee: $0 (but accepting free will offerings)
Usual Location: ST. CATHERINE PARISH CENTER MEETING ROOM
Usual day and time:
ALTAR GUILD: 1st and 3rd TUESDAYS (Mar - May)
KENOSIS: 2nd and 4th MONDAYS (Aug - Oct) & 2nd & 4th TUESDAYS (Nov-May), 3pm – 4:30pm
Routine Activities: SNACKS, GAMES, PRESENTATIONS, SMALL/LARGE GROP
DISCUSSION, SKITS, ETC.
Group Leader: JOHN DAVID KIMES, Coord. of Relgious Education
Telephone No.: 260-341-3004
Transportation: NOT PROVIDED BY PARISH/SCHOOL
Other Information, email: More information can be found at www.stcatherineofsiena.org/youth-ministry, or contact John David Kimes at jdkimes@stcatherineofsiena.org
I have carefully read and understand and accept the terms and conditions stated herein and I acknowledge and agree that this Permission, Release, and Authorization to Seek Medical Treatment shall be effective and binding upon me, my Child, and our personal representatives, estates, assigns, heirs, and next of kin. I have signed below of my own free will.