Medical Information and Liability

As the parent of the registered youth(s), I understand and acknowledge that participation in activities involves inherent risks of injury to my child. I agree to indemnify The Basilica of Saint Mary’s Catholic Church, its employees, staff, ministers, volunteers, and the Diocese of Arlington for any consequences or costs or expenses arising out of my child’s participation in the activities including the cost of any medical care given my child or any expenses or fees incurred in any lawsuit arising as a result of any damage or injuries caused by my child in the course of his or her participation in the activity.

I further give my consent to that in my absence the above-named minor be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment of the above minor. I have not been given a guarantee as to the results of examination or treatment. I authorize the hospital or medical facility to dispose of any specimen or tissue taken from the above-named minor.

Photographs

A parent may withhold permission to have a child photographed and/or videotaped during Religious Education at The Basilica of Saint Mary’s.

If you do not want your child to be photographed and/or videotaped, please send notification in writing to The Basilica of St Mary's Office of Religious Education with the name of your child(ren) stating: DO NOT allow my child(ren) to be photographed or videotaped during Basilica of Saint Mary’s CCD.

Photographs taken during CCD activities may be selected for promotional use by The Basilica of Saint Mary’s staff.

I understand that a parent or an approved adult (21 years and older) may drop-off and pick-up my child/ren from the SPRED Program and escort the child/ren to and from the classroom. We ask for the parent/approved adult to arrive on-time.