First Reconciliation/First Communion Registration Form Middle School and High School

Fields marked with an * are required

*Please type all names as they appear on legal documents and attach a copy of Baptismal certificate.

Student #1

Liability Release - By checking the box below, you are "signing" this document.

I grant permission for my child to participate in youth activities at STOC. I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. If I give approval over the phone, I hereby grant permission for the parish, through its officers, to give nonprescription medication (such as aspirin, throat lozenges etc.) to my child, if deemed advisable. If taking medication at present, my child will bring all such medications necessary and release them to the adult representative in charge for distribution to my child. Such medications will be well labeled with names of medications, concise directions for seeing that the child takes such medications, including dosage and frequency of dosage. In the event of an emergency, I hereby give permission 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. As parent, or legal guardian, I remain legally responsible for any personal actions taken by my child. I agree to hold harmless and defend St. Therese of Carmel, its officers, directors and agents, Diocese of San Diego, and representatives associated with Sacramental Preparation for Teens with respect to any and all actions, claims or demands that may be made or brought against the above named parties associated with the event, arising from or in connection with my child’s attending the event or in connection with any illness, injury or cost of medical treatment in connection therewith. I agree to compensate the parish, its officers, directors and agents, and the Diocese of San Diego, or representatives associated with the event for reasonable attorney’s fees and expenses arising in connection therewith.