Child/Youth Release Form - Episcopal Diocese of San Diego Child/Youth Release Form - Episcopal Diocese of San Diego

Child/Youth Release Form

The Episcopal Diocese of San Diego 2017 Diocesan Convention Release of Liability

For and in consideration of the participation in the trip to the diocesan convention of the Episcopal Diocese of San Diego.

I acknowledge and agree that:

  1. By virtue of my participation I risk serious bodily injury;
  2. I knowingly and freely assume all such risk;
  3. I (we), the undersigned parent(s)/guardian(s) do release, hold harmless and promise not to sue the Episcopal Diocese of San Diego, their officers, agents, employees, with respect to any and all such injury, except that injury or loss which results from gross negligence or willful or wanton misconduct of one of those individuals or organizations.
  4. I will inform my child that he/she must follow all safety rules and instructions or directions given during participation in the trip, and that my child’s failure to follow instructions may result in my obligation to retrieve my child if requested.  My child and I (we) realize that participation in the trip is voluntary.
Youth Convention Release Form

This is to certify that as a parent/guardian of this participant, I do consent to his/her waiver and release as set forth above for participation at the Episcopal Diocese of San Diego's 44th annual convention.

Authorization for Medical Treatment of a Minor

Diocesan Convention November 10 & 11, 2017 Period covered

Diocesan Youth Ministries • Medical Release

I give permission for my son/daughter to attend events with the Episcopal Diocese of San Diego. I also give my permission for my son/daughter to receive any treatment deemed necessary under the general or special supervision and upon the advice of a physician and/or surgeon licensed under the provision of the Medical Practice Act. I understand that every attempt will be made to contact me should such a situation arise.
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