Parent's Name
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First Name
Last Name
Parent's Name
First Name
Last Name
Child Participant's Name
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First Name
Last Name
Child's Date of Birth
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MM
DD
YYYY
Gender (Male or Female)
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Parent's Phone Number
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Parent's Phone Number
(###)
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Parent's Email
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Date of Participation
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Activity Participating In:
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CONSENT TO PARTICIPATE AND LIABILITY RELEASE: In consideration for allowing registering Participant to participate in this activity, I / We, the parent(s)/guardian(s)/conservator(s) of the Participant grant permission for my/our son/daughter to travel to and participate in the Event described in this form. I/we assume all risks and hazards incidental to the participation in the Event, including transportation to and from the Event. In consideration for allowing this minor to participate in the event listed above, and on behalf of myself/ourselves and Participant’s parents, legal guardians, siblings, heirs, assigns, and personal representatives, I/we hereby release and agree to fully and unconditionally protect, indemnify, and defend the Parish(es)/School(s) hosting this Event, the Roman Catholic Diocese of Dallas, and their respective officers, agents, and employees, (collectively, “Indemnitees”) and hold each Indemnitee harmless from and against any and all costs, expenses, attorney’s fees, claims damages, demands, suits, judgments, losses, or liability for injuries to property, injuries to persons (including Participant) and from any other costs, expenses, attorney fees, claims, suits judgments, losses, or liabilities of any and every nature whatsoever arising in any manner, directly or indirectly, out of, in connection with, in the course of, or incidental to the minors participation in the Event, REGARDLESS OF CAUSE OR OF THE JOINT, COMPARATIVE OR CONCURRENT NEGLIGENCE OF THE INDEMNITEES. In the event any legal action is taken by either party against the other party to enforce any of the terms and conditions of this release, it is agreed that the unsuccessful party to such action shall pay to the prevailing party therein all reasonable court costs, attorneys’ fees, and expenses incurred by the prevailing party.
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MEDIA RELEASE: On occasion, video recordings, audio recordings, photographic slides, and photographs are taken of minors during church and diocesan sponsored activities. These are utilized in newsletters, websites, event promotion, advertisements and other printed media. For good and valuable consideration, I hereby grant to the parish(es) &/or diocese leading the registering Event the irrevocable and unrestricted right to make, use and/or publish any and all photographs, videos, and other images of me/my minor child(ren) listed on this registration form , or images in which me/my minor child may be included, now existing or hereafter made, in any case, with or without identifying subject for editorial, advertising, news, or any other purpose and in any manner and medium; to alter the same without restriction; and to copyright the same. I hereby release and agree to fully and unconditionally protect, indemnify, and defend any parish(es) described on this registration form), the Roman Catholic Diocese of Dallas, and their respective officers, agents, and employees, (collectively, “Indemnitees”) and hold each Indemnitee harmless from and against any and all costs, expenses, attorney’s fees, claims damages, demands, suits, judgments, losses, or liability for injuries to property, injuries to persons (including the participating minor) and from any other costs, expenses, attorney fees, claims, suits judgments, losses, or liabilities of any and every nature whatsoever arising in any manner, directly or indirectly, out of, in connection with, in the course of, or incidental to the use or publication of any photographs, videos, or other images of my child, REGARDLESS OF CAUSE OR OF THE JOINT, COMPARATIVE, OR CONCURRENT NEGLIGENCE OF THE INDEMNITEES.
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Parental/Guardian Signature/ Consent: I have read the consent to participate & liability release and media release, and I understand and voluntarily agree to their provisions.
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Today's Date
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MM
DD
YYYY
