Youth Ministry (8th - 12th Grade) Permission, Medical, & Consent Form

As part of the ministry named above, the Youth Ministry Coordinator may employ electronic communications such as group messaging or mass e-mails to keep participants informed. These communications will only be used for Youth Ministry purposes such as announcements, scheduling of events, and similar notifications. The Diocese of Sacramento's policy is that ministry leaders may not engage in one-on-one communications with minor children except in urgent pastoral care. Even in this scenario, another adult will be brought into the conversation. Parents and guardians are seen as partners in our efforts to keep children safe, and you will be included in group communications that are sent to your minor child.

This form will be filed in a confidential folder for St. Dominic & Youth Ministry use only. The person(s) being authorized to engage in group communications with the minor child is in compliance with the Diocese of Sacramento's Safe Environment Policy with St. Dominic's Catholic Church.

St. Dominic's Youth Ministry has chosen to use Email as the group communication channel. If you do not wish for your teen to receive emails, please leave "Teen Email Information" blank.

I/we the undersigned parent or guardian of the child named on this form give permission for my/our child's participation in confirmation and youth ministry activities. In addition to the health and medical information provided and agreed to in this registration form, we agree to the following:

• Direct Child to Cooperate: I/we agree to direct my/our child to cooperate and comply with all reasonable directions and instructions from parish/school/diocesan staff or adult volunteer leaders.
• Consent for Transportation (if applicable): I/we give permission for my/our child to be transported to and/or from the specified programs, events, and activities in vehicles driven by adult leaders selected by the parish/school/diocesan coordinator, or by bus, in accordance with diocesan guidelines.
• Responsibility for Medical Expenses: I/we agree to be responsible for all medical expenses relating to injury of my/our child as a result of his/her participation in an activity, whether or not caused by the negligence of the parish, school, or diocesan employees, agents, volunteers or other participants.
• Acknowledgment of Risks: I/we understand that in the course of participating in activities, my/our child may risk injury to the body, psyche, or property of themselves and others. Such injuries can be caused by other persons, may be accidental or self-inflicted, or may arise from faulty equipment or facilities, existing conditions of recreational facilities, vehicle accidents while in transport during an activity, or through the activity itself.

Accordingly, in consideration for being permitted to participate in the specified activities, to use the equipment provided, and to enter the premises and facilities of the Diocese of Sacramento, for any purpose including observation of and participation in activities, the undersigned parent or guardian, for him or herself and any successors in interest, and on behalf of the minor child, agrees as follows:

1. To release, waive, discharge, and promise not to sue the Roman Catholic Bishop of Sacramento, a corporation sole, and its affiliated entities, employees, agents, and volunteers (the "Diocese") from all liability for any loss or damage, and any claim or demands therefore on account of injury to the body, injury to psyche, or injury to property of the minor child, or to undersigned parent or guardian, whether caused by negligence or other conduct by the Diocese while the minor child, parent, or guardian is participating in the specified activities or in, upon, or about the premises of the Diocese or any of its facilities or equipment.
2. To indemnify and hold harmless the Diocese from any loss, liability, damage, or cost it may incur due to the acts of the minor child, parent, or guardian in, upon, or about the premises of the Diocese, its facilities or equipment, or while participating in any parish, school, or diocesan activities whether caused by negligence or otherwise.
3. In the event of an emergency, I the undersigned parent/guardian of the child named on this form herby give permission to the Diocese of Sacramento, parishes and schools within the Diocese and their employees, agents, representatives, and adult volunteers to arrange for and authorize emergency medical, dental, or surgical treatment for my child as considered necessary by the attending physician. I wish to be advised prior to any further treatment by the hospital or doctor.
4. My son/daughter will follow current Covid-19 safety precautions provided by St. Dominic's Parish. This may include social distancing and masking. A child should not attend a meeting or activity if recently exposed to Covid-19 and a child should not attend any meetings if sick (for example, runny nose, fever, cough, sneezing, upset stomach).
5. Permission Form for Video/Audio/Photography/Media: I understand that the School/Parish/Diocesan Entity identified above and Diocese of Sacramento (collectively herein, "the Diocese") may conduct some youth ministry and confirmation gatherings via the internet, thorough livestreamed sessions that may be recorded by the Diocese. If the content is recorded by the Diocese, there is a possibility that identifying features of a participating child (name/face/voice) will be also be recorded during the session. I understand that to protect the privacy of all children participating in on-line youth ministry activities, the participants in such activities (except the Diocese, as set forth above) are strictly forbidden from taking screen shots or recordings during any livestreamed session. I understand that during ministry events, ministry leaders or other representatives of the Diocese may take photographs or videos during the event, and that those photographs or videos may therefore include the images of children who are participating. I understand that as part of the Diocese's desire to evangelize and promote youth ministry, photographs and video recordings may be used by the Diocese in ways that include, but are not limited to, posting on Parish or Diocesan websites or social media, or inclusion in bulletins or other written publications of the Diocese, and that video or photographs used in that manner may include the images of children who have participated in youth ministry events and activities.
   1. I hereby grant to the Diocese the right to make, use, and/or publish any and all videos, photos, media, audio, or other images of my minor child, to the extent those materials are captured during youth ministry activities, now existing or hereafter made, with or without identifying him/her, for the uses described above.
   2. I hereby release and agree to fully and unconditionally defend, indemnify, and hold harmless the Roman Catholic Bishop of Sacramento, a corporation sole, and any pertinent Parish corporation, or other diocesan entity corporation, and their clergy, officers, agents, employees and volunteers, from any claims, costs or expenses for property damages, personal injuries, or other damages that may arise out of my minor child's participation in youth ministry activities.
   3. I understand and agree that if I wish to revoke my permission given in this Permission Form, I must do so in writing and inform the Parish or Diocese. Otherwise, it will remain in full force and effect through the Term of Permission identified above.

By providing an electronic signature or written signature on this registration form, I confirm that I have read the consent form and agreement and am voluntarily signing it, and that no oral representations statements, or inducements apart from the contents of this form have been made. I/we have read this agreement and understand and agree to everything set forth above.