Permission Forms and Liability Wavers

Registration for Parish Youth Events Oct 5: LIFELINE Mass Oct 9: Confirmation to 40 Days for Life Prayer Vigil Oct 25: Youth Group 40 days for life Prayer Vigil and Jakes Pizza Jan 4: LIFELINE Mass Jan 18-20 Riverbend TEC Retreat Jan 23-27: March for LIfe and Youth Festival in D.C. with the IVE! Feb 1: LIFELINE Mass Feb 15-17: Pathways TEC Retreat

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Age REQUIRED Please fill out this field. Please enter valid data.

Parent or Guardian Name REQUIRED Please fill out this field. Please enter valid data.

Date REQUIRED Please fill out this field. Please enter a date.

Email Address Please enter valid data.

Emergency Contact (name and number) REQUIRED Please fill out this field. Please enter valid data.

Medical Information

Phone Number REQUIRED Please fill out this field. Please enter valid data.

In Consideration of the opportunity for my child to participate and fully recognizing that such an undertaking involves an element of risk, I/we assume all risks and hazards incidental to such participation and do hereby release, absolve, indemnify, and agree to hold harmless the Parish of Ss. Peter and Paul, the Diocese of Winona, its agents, employees, and officers and the chaperones, leaders, organizers, sponsors, and people transporting our child to and/or from these activities.

I here by consent to participation by my child in the event described above. I further consent to the conditions stated above on participation in this event, including the method of transportation.

I Agree Please select this field.

Parent Signature REQUIRED Please fill out this field. Please enter valid data.

Photo Release REQUIRED Ss. Peter and Paul Youth Ministry is allowed to use photos of my child from this event Ss. Peter and Paul Youth Ministry is not allowed to use photos/videos of my child from this event Please fill out this field.