Medical Consent/Liability Waiver

(18+) In the event of an emergency, I hereby give permission to the staff of Mary Queen Catholic Church to seek emergency medical transport or treatment for myself. I wish to be advised before further care is given by the hospital or doctor and I understand that all financial obligations are my responsibility. If I cannot be reached please contact the person listed above.

In consideration of my participation in Vacation Bible School, I agree on behalf of myself, and my heirs, successors, and assigns, to indemnify, hold harmless and defend the Daniel Cardinal DiNardo, Archdiocese of Galveston-Houston, Mary Queen Catholic church, its pastor or any representative of Faith Formation or Youth Ministry (collectively the "indemnitees") from any and all injuries, losses or claims arising out of my participation in the program. I further agree that if anyone on my behalf makes a claim against the indemnitees, I will indemnify, save, and hold harmless each of the indemnitees from any litigation, expenses, attorney fees, loss, liability, damage or cost which may incur as a result of such claim.

(Under 18) In the event of an emergency, I hereby give permission to the staff of Mary Queen Catholic Church to seek emergency medical transport or treatment for my child(ren) named above. I wish to be advised before further care is given by the hospital or doctor and I understand that all financial obligations are my responsibility. If I cannot be reached please contact the person listed above.

In consideration of my child's participation in Vacation Bible School, I agree on behalf of myself, my child(ren) named above, and our heirs, successors, and assigns, to indemnify, hold harmless and defend the Daniel Cardinal DiNardo, Archdiocese of Galveston-Houston, Mary Queen Catholic church, its pastor or any representative of Faith Formation or Youth Ministry (collectively the "indemnitees") from any and all injuries, losses or claims arising out of my child's participation in the program. I further agree that if anyone on my child's behalf makes a claim against the indemnitees, I will indemnify, save, and hold harmless each of the indemnitees from any litigation, expenses, attorney fees, loss, liability, damage or cost which may incur as a result of such claim.

Video/Photography Consent

(18+) I understand that promotional pictures and videos (individual and group) may be taken during Vacation Bible School. I give permission for my pictures to be used for church promotional materials such as newsletters, web pages, social media, calendars, power point presentations, or videos to promote or highlight these classes or activities.

(Under 18) As parent/guardian, I understand that promotional pictures and videos (individual and group) may be taken during Vacation Bible School. I give permission for my child(ren)'s (named above) pictures to be used for church promotional materials such as newsletters, web pages, social media, calendars, power point presentations, or videos to promote or highlight these classes or activities.

Note: All volunteers who are 18 years old or older must complete or have completed the Safe Environment program to participate. 

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Total for t-shirt: $10