Parental Consent:
I/we consent to my child, participating in the above-described activities/program. I/we specifically waive and release any and all claims of any nature which I/we may have now or in the future against the above named parish and/or school, the Diocese of Metuchen, their representatives, employees, agents and assigns (including, but not limited to, staff and adult supervisors) arising out of, related to, or connected in any way with the above described activity including, but not limited to, claims that may be derived from any accident or injury sustained by my child or damages or loss to property in route to, during, and/or returning from the activity.
Authorization for Medical Treatment:
Should emergency medical treatment be necessary and I/we cannot be reached immediately, I/we authorize the delegated agents of the above-named parish to consent to medical or surgical treatment of an emergent or non-emergent nature, including in-patient or out-patient hospitalization, to be rendered to my child under the general or special supervision and advice of a physician, surgeon or dentist. Such consent may include but is not limited to, medical or surgical diagnosis or treatment, diagnostic tests, blood tests, x-rays, transfusions, intravenous treatments, administration of medication or anesthetics, and any related procedures that may be deemed advisable or necessary. It is understood that this
authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power to the delegated agents of the above-named parish to give specific consent to any and all such
diagnosis, treatment, or hospital care which the aforementioned physician, surgeon or dentist, in the exercise of his/her
best judgment, may deem advisable. I/we understand that I/we assume all financial responsibility for the delivery of such
care at the time that such care is provided by the agency, hospital, or facility. I/we further understand that Diocesan
and/or parish representatives are NOT permitted to dispense medication–unless parents previously discussed a child’s
need for a specific mediation also noted on this form. In the event that my child requires medication during the above-described activity,
I/we understand that my child must be trained to self-administer medication or have a parent in attendance to administer medication.
Photo Release
I/we hereby grant to the Diocese of Metuchen and its parishes, schools and assigns the irrevocable and unrestricted right
to use, reproduce and publish photograph(s) or video(s) of my child, including their image and likeness for diocesan, parish or school publications, advertising, or website(s), or any other purpose and in any manner and medium; to alter the
same without restriction; and to copyright the same.
I/we hereby release The Diocese of Metuchen and its trustees, officers, employees, agents, legal representatives, and
assigns from any and all claims, actions, and liability of whatever nature and relating to the use of the said photograph(s)
and/or video(s).