I/We, parent(s)/guardian(s) named above, grant permission for my/our child (named above) to participate in this school/parish/diocesan event. This activity will take place under the guidance and direction of school/parish/diocesan employees and/or volunteers from St. Martin de Porres Catholic Church.

As parent(s)/legal guardian(s), I/we remain legally responsible for any personal actions taken by the above-named minor participant. I/We agree on behalf of myself, my/our child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Martin de Porres Catholic Church, its officers, directors, employees, and agents, and the Diocese of Orange, its employees and agents, chaperones, or representatives associated with the event, from any claim arising from or in connection with my/our child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith. I/We agree to compensate the parish/school, its officers, directors, and agents, and the Diocese of Orange, its employees, agents, chaperones, or representatives associated with the event for reasonable attorney's fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the parish/school or the Diocese of Orange.

I/We authorize the making of photographs, motion pictures, video tapes, recordings, or other memorializing of said event and my/our child's participation therein, and the publication and duplication or other use thereof. I/We waive any rights to compensation or any right that I/we otherwise might have to limit or control such making or use.

I/We give permission to the physician, nurse, dentist, or licensed care staff selected by the supervisory personnel then present to render medical, dental, or other appropriate treatment deemed necessary and appropriate by the physician, nurse, dentist, or licensed care staff.

ADULTS

YOUTH

CHILDREN

FAITH FORMATION

WORSHIP

COMMUNITY LIFE

SERVICE

COMMUNITY

OUTREACH

Eucharist 2