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Join us for a fun night for teens!

Parent/Guardian Acknowledgment: To the best of my knowledge, my child is in good health for this activity. In the event of an emergency, I hereby give permission to seek medical treatment from available health professionals or transport my child to a hospital for emergency medical or surgical treatment as necessary. The hospital or doctor will advise you prior to any non-emergency treatment per their policies.

In the event of an emergency, if you are unable to reach me at the above numbers, contact: (at least one contact is required)

I grant permission for my child (named above) to participate in this event. It is understood that reasonable caution will be taken by those persons in charge to prevent injuries. I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend Little Flower Parish, its school, officers, directors, employees and agents, and the Archdiocese of Washington, its employees and agents, chaperons, or representatives associated with the event, from any claim arising from or in connection with my child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors and agents, and the Archdiocese of Washington, its employees and agents and chaperons, or representative 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/diocese. Permission is hereby granted to the Archdiocese of Washington and Little Flower Parish to use the photographs and quotations of my son/daughter to assist in community awareness, educational efforts, related public relations purposed that may include brochures, posters, website and print media from the Archdiocese of Washington. My child agrees to abide by all rules and regulations as outlined in the Code of Conduct available on our parish website. I understand that the Office of Youth Ministry and the Archdiocese of Washington will not be held liable if my child fails to cooperate with said regulations and that any infractions of the rules may result in immediate dismissal from this event. As parent and/or guardian, I remain legally responsible for any personal actions taken by the above named participant.

I understand and agree that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.​​