March for Life cost:175.0
We, the parent(s) or guardian(s) permit our son to attend the 2019 March for Life pilgrimage to Washington, D.C. being planned by the Office for Vocations on January 17-20, 2019. The purpose of this trip is: support the beauty and dignity of every human life, fraternity, education of our nation's capital and the Catholic Church.
We, as parent(s) or guardian(s) of the undersigned minor(s), hereby consent and agree to hold harmless our parish of registration and/or the Roman Catholic Diocese of Lafayette-in-Indiana, Inc., and any and all employees or volunteers thereof, for any accident, injury or occurrence arising out of, or in connection with, our son’s participation, including the transportation necessary to participate in aforementioned activity. We understand that our son may be assigned to ride with a licensed adult driver, driving a rented or privately owned automobile or school bus, and that this assignment will be made by the aforementioned staff member.
I give my permission for my son, in case of an emergency, to be taken to a physician or hospital by either a parent in charge or by diocesan personnel. I understand that every effort will be made to contact me. If I cannot be reached, I hereby give permission to the physician selected by the parish member in charge or adult chaperone to secure proper treatment for my son.
MEDICAL MATTERS: I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibilities for the health of my child. Of the following statements pertaining to medical matters, select only those in accordance with your wishes.
Emergency Medical Treatment: In the event of an emergency, I hereby give permission to the Office for Vocations, its officers, directors and agents, and Diocese of Lafayette-in-Indiana, agents, representatives, volunteers and employees of either the diocese or any parish thereof, and chaperones or representatives associated with this event to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, the emergency phone number provided in the above registration will be contacted.
Other Medical Treatment: In the event it comes to the attention of the Office for Vocations, its officers, directors and agents, and the Diocese of Lafayette-in-Indiana and all parishes within the diocese, and the officers, agents, representatives, volunteers and employees of either the diocese or any parish thereof, and chaperones or representatives associated with the event, that my child becomes ill with symptoms such as headache, vomiting, sore throat, fever, diarrhea, I want to be contacted by phone.
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