MIDDLE SCHOOL RETREAT

I hereby authorize and give full consent, without limitations or reservations, to the Parish of Santa Clara de Asis and the Diocese of Orange to publish any photographs or videos in which the named child(ren), parent(s) or grandparents(s) appear while participating in any program with the Parish of  Santa Clara de Asis.  There will be no compensation for use or any photographs or videos at the time of publication or in the future.

I, the undersigned, as the parent or legal guardian of the above named child/children, do hereby give permission for him/her/them to participate in any of the activities conducted by in any program with the Parish of  Santa Clara de Asis in Yorba Linda, CALIABILITY RELEASE:  I also hereby release, forever discharge and agree to hold harmless the Parish of  Santa Clara de Asis  and the Diocese of Orange and the directors thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the above named child/children that occur during any program with the Parish of  Santa Clara de Asis.  Furthermore, I hereby assume all risk and personal injury, sickness, death, damage, and expense as a result of participation in these activities.  Further, authorization and permission is granted to furnish any necessary transportation, food, lodging required for the activities.  The undersigned further hereby agrees to hold harmless and indemnify the Parish of  Santa Clara de Asis, its directors, employees or agents, for any liability sustained by said church as the result of the negligent, willful or intentional acts of the named child(ren), including expenses incurred attendant thereto.MEDICAL RELEASE:  I attest that the named child(ren) is/are in good physical condition.  Should any accident or illness occur during any program with the Parish of  Santa Clara de Asis, I will not hold Parish of Santa Clara de Asis or its directors responsible for medical aid rendered and will reimburse them for the medical and other expenses incurred.  The named child(ren) may receive necessary first aid and if necessary medical attention by any duly licensed physician, and may be admitted into a hospital in case of emergency.DISASTER PREPAREDNESS:  In case of disaster, my child(ren) may be released into the care of a parent, legal guardian, or the listed emergency contact person(s).