MEDICAL MATTERS: I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I hereby give permission to St. Catherine’s Church and its representatives or volunteers to hospitalize, secure proper treatment for, and to order injection and/or anesthesia and/or surgery for my child.
RELEASE: For and in consideration of the above child being allowed to participate in this program, and other valuable consideration, the undersigned parent, guardian, or legal representative, on behalf of the child and child’s parents, personal representatives, assigns, heirs and next of kin, do hereby release and hold harmless the Diocese of St. Augustine, Bishop Felipe Estevez, as Bishop of St. Augustine, a corporation sole, Bishop Felipe Estevez, individually, and St. Catherine of Siena Catholic Church, an entity of the diocese, all organizers of this program, all volunteers, chaperones, employees and agents of said parties, their personal representatives or assigns, from any loss or damage on account of any injury to the person or the personal property of the child, or death, caused by negligence or otherwise, while the said child is engaged in the above program, any activities of the program, or while being transported to or from the program. The undersigned agrees that this release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Florida, and that if any portion of this Agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. The undersigned parent, guardian, or legal representative, further acknowledges that he/she is authorized to enter into this Agreement on behalf of the child, and the child’s parents, personal representatives, assigns, heirs, and next of kin. I further authorize any representative of this program to obtain medical treatment for my child in the unlikely event of an injury or illness during this program and I agree to pay any expenses incurred for such treatment.