Diocese of Superior Permission Form for Minors with Indemnity Agreement and Emergency Contacts

Event Information Description of Event: __High School Retreat
Date of Event: _9/28/24-9/29/24
Begin time: __4:00PM Saturday, 9/28/24_
End time: _4:00PM Sunday 9/29/24
Transportation: NOT PROVIDED
Participant cost: $100/student (unless retreat is being used to fulfill confirmation requirement, then cost is covered by the parish)
Sponsored by: NLCC and Nativity of Our Lord in Rhinelander, WI
Supervised by:Kyle Parish and Kira Bender and Scarlet Sweeney

Your permission is needed for your child to participate in the event listed above. Please return this signed form no later than _September 4, 2024 to Kira Bender

I give permission for my child to participate in the above named event. My submission of this form indicates that I understand the risks and hazards associated with the event this event, including injury, illness and the rare possibility of death. I understand that I may discuss any concerns or questions I have about this event with a representative of the parish or Diocese of Superior prior to giving permission for my child to participate. In consideration for my child’s participation, I agree to reimburse and indemnify the above named parish and the Diocese of Superior for all reasonable legal and court fees incurred by the parish/diocese in defending a lawsuit that I or my child may bring against the parish/diocese which relates to the above named event if the parish/diocese is found not legally liable by the courts and prevails in the lawsuit. If the parish/diocese is found legally liable for any injuries sustained by my child, this paragraph will not apply. I further agree to reimburse the diocese or any other agency for property damage or any bodily harm to other participants caused by my child.

A MEDICATION CONSENT FORM MUST BE COMPLETED AND THE PRODUCT SUPPLIED FOR EACH MEDICATION