Holy Week Family Permission Slip Form

Holy Week Family Permission Slip Form

Holy week family permission slip form Form Preview
Holy Week Family and Over 18 Permission Slip
  • Permission to Participate in Activities 2014-2015 Mission Network Activities USA, INC

  •  -  - Pick a Date
  •  -
  •  -
  • Nature and Duration of Activities: Mission work including prayer, Mass, preparing and running kid's camps, various assistance in parish activities, door to door missions in neighborhoods close to parish, evening activities with the other missionaries, and various corporal or spiritual works of mercy. Registration begins at 6:30 P.M. Wednesday,  April 1st, 2015, and the Mission ends after the Easter Vigil on April 4th, 2015   

  • 1. Activity Supervisors

    Priests of the Legionaries of Christ, Consecrated women of Regnum Christi, Adult chaperones, college-aged volunteers.
  • 2. Transportation

    Transportation is not provided by Mission Network Activities USA, Inc itself. Some volunteers have offered to drive their vehicles to carpool the missionaries. By signing below you acknowledge and accept transportation from individual members and not by Mission Network Activities USA, Inc itself.
  • 3. Requirements

    The participants named above are in good health and has no physical or medical limitations that would cause the activities as described above to be detrimental or dangerous to the participant. Specific allergies and medical problems are indicated below:
  • 4. Consent

    The above named participant certify that he/she is above the age of majority and hereby consents to participate in the activities described above, and specifically requests that he/she be allowed to participate in those activities.
  • 5. Authorization:

    The above named participant authorizes Mission Network Activities USA, Inc to use the image and likeness of him/her in photograph or video form whether taken by or commissioned by Mission Network Activities USA, Inc in its promotional materials and for its promotional purposes associated with its non profit activities. This authorization shall extend to use of his/her image and likeness on the website of Mission Network Activities USA, Inc or its successor in operation or affiliated organization(s) upon written consent of Mission Network Activities USA, Inc. The above named participant understands that this authorization shall survive the end of his/her participation in the activities referenced on this form.
  • 6. Insurance

    The above named participant understands that Mission Network Activities USA,Inc. does not carry any insurance relative to the activities or for any injury that may occur to him/her. The above named participant represents that he/she is (a) covered by insurance through my own insurance carrier; or (b) that he/she is personally financially responsible for any and all medical costs incurred as a result of the child's injury.
  • 7. Emergencies

    If the above-named participant requires any emergency medical treatment or procedures during the activities, he/she hereby consents to the activity supervisor(s) taking, arranging for or consenting to such procedures or treatments in the discretion of the activity supervisor(s).
  • 8. Emergency Contacts

    If, in the event of a medical or other emergency,the above named participant authorizes the activity supervisor(s) to contact me through the emergency contacts listed below.
  •  -
  •  -
  • 9. Release and Identification

    I/We release and waive, and further agree to indemnify, hold harmless or reimburse Mission Network Activities USA,Inc. and Consolidated Catholic Administrative Services, Inc. the individual members, agents, directors, officers, employees, volunteers, and representatives thereof, as well as activity supervisors, from and against, any claim which I, any other parent or guardian, any sibling, the above-named child, or any other person, firm or corporation may have or claim to have, known or unknown, directly or indirectly, for any losses (including attorney fees incurred by Mission Network Activities USA, Inc. and Consolidated Catholic Administrative Services Inc. or any of its individual employees, agents, volunteers, etc in enforcing this indemnity provision) with out limitation in time or amount, damages or injuries arising out of, during, or in connection with my/our child's participation in the activities, the traveling to and there from, and the rendering of emergency medical procedures or treatment, if any. I/We understand that this release and indemnification shall survive the end of my/our child's participation in the activities referenced on this form and shall have no limitation in time or amount.
  •  -  - Pick a Date
  • Should be Empty: