I grant permission for my child {teenName} to participate in the event described above.
I agree on behalf of myself, my child {teenName}, our heirs, successors, and assigns to hold harmless and defend the Diocese of Birmingham in Alabama, its Bishop, Parishes, Employees and Volunteers from any liability for illness, injury or death arising from or in connection to my child’s attendance at the event described above.
To the best of my knowledge, my child {teenName} is in good health, I assume all responsibility for the health of my child. In the event of an emergency, I give permission to transport my child for emergency treatment. I wish to be advised prior to any treatment by a hospital, clinic or doctor. I have noted any and all health/diet concerns on the second page of this form.
As parent/legal guardian, I remain legally responsible for any actions taken by my child {teenName}. My child will conduct himself/herself in a proper and respectful manner. I understand that failure to abide by standard codes of conduct will cause my child to be dismissed from the above named event. I agree that if my child is dismissed from the event I will travel (or send an adult designee) at my expense to the event location and retrieve my child.