Youth Group Permission Slip Posted November 6, 2018 Youth Group Permission Slip Youth Group Permission Slip LinkedInThis field is for validation purposes and should be left unchanged.Teen Name* Teen Name Teen Email Address* Parent Name* Parent Name Parent Email Address* Safety: By signing the below, I agree that my child will follow all procedures, safety precautions, and rules and regulations set forth by the Diocese and the Parish.Parental Permission and Liability Release: As parent/legal guardian of the participant named above, I give my permission to participate fully in the Youth Group Program at St. Theresa Catholic Church. I agree to indemnify and hereby release the Most Reverend Michael F. Burbidge of the Catholic Diocese of Arlington and his successors in office, as well as the Catholic Diocese of Arlington and all Diocesan clergy, employees, volunteers, and participating parishes and schools from any and all liability, claims, demands for personal injury, sickness and death, as well as property damage and expenses of any nature whatsoever which may be incurred by the undersigned of the participant resulting from said participant’s involvement in the above mentioned event (including transportation to and from the event). Furthermore, I on behalf of the participant hereby assume all risk of personal injury, sickness, death, damage, and expenses resulting from said participant’s involvement in the above-described event. Photo, Press, Audio, and Electronic Media Release: I authorize the Catholic Diocese of Arlington, its parishes, its schools and/or the Arlington Catholic Herald to use and publish my child’s photograph, video and/or audio recording along with their name identifying them for educational, news stories, illustration and/or marketing purposes. Signature
