VBS Activity Permission Form

  • As a convenience to parent(s) or guardian(s), all children attending the program can be listed on this form

  • A. On-Going Program at St. Ignatius of Loyola Church. Vacation Bible School Starting on July 29, 2019 and ending on Aug 2, 2019
  • Registration Fee

    $20 per child
  • Usual Location:

    St. Ignatius Parish Campus; Father Hilvert Center and St. Ignatius School building
  • Usual day and time:

    July 29- Aug 2, 2019 ~ Monday - Friday 9 a.m. – 12:00 p.m.
  • Routine Activities:

    Vacation Bible School activities
  • Group Leader:

    Elaine Kroger, CRE
  • Telephone Number

    Weekdays 661-6565 EXT. 2725
  • give permission for my child(ren) to participate in activities and release from all liability and indemnify the Archbishop of Cincinnati (“the Archbishop”), both individually and as trustee for the Archdiocese of Cincinnati and all parishes within the Archdiocese, and their officers, agents, representatives, volunteers, and employees from any and all liability, claims, judgments, cost or expenses, including attorney fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from activities.
  • I agree to instruct my child(ren) to cooperate with the Archbishop or his agents in charge of the activity.
  • I appoint the Archbishop or his agents who are acting as leaders of the activity as my attorney in fact to act for me in my name and my behalf, in any way that I would act if I were personally present, with respect to the following matters if any injury, illness or medical emergency occurs during activities or related travel: i). To give any and all consents and authorizations to any physicians, dentist, hospital or other persons or institutions pertaining to any emergency medications, medical or dental treatments, diagnostic or surgical procedures or any other emergency actions as our attorney shall deem necessary or appropriate for the best interest of the child(ren). ii). I understand that the agents of the Archbishop will make a reasonable attempt to contact me as soon as possible in the event of a medical emergency involving my child(ren).
  • This permission, release and medical power of attorney shall be deemed valid for the Parish School of Religion ministry on Sunday mornings.
  • If any change occurs in the information provided by parent or guardian with respect to emergency contacts or medical information, the appropriate agent will be provided with written notification of such changes as soon as possible.
  • I agree that the Archbishop or his agents may use my child(ren)s portrait or photograph for promotional purposes and office functions.
  • I have carefully read this statement, and my signature acknowledges that I fully understand the content and meaning, that I give permission for my child to attend Vacation Bible School and that my child’s medical information form is on file and accurate.

  • Date Format: MM slash DD slash YYYY
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