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Form A

- Youth

ANNUAL PERMISSION FORM & GENERAL RELEASE FOR MINORS: RELIGIOUS FORMATION & ACTIVITIES

The Roman Catholic Archdiocese of Oklahoma City (“Archdiocese”) strives to provide religious formation to all the minors entrusted into its care, including your son or daughter (“Participant”), as part of its religious mission to assist parents in fulfilling their sacred vocation to form each child as a disciple of Jesus Christ (cf. Catechism of the Catholic Church, n. 2201-203; 2221-231). As you, the custodial parent and/or legal guardian (“Parent”), desire for the Participant to receive such formation from the Archdiocese and engage in religious formation, events, or similar activities (“Activities”) at the Cathedral of Our Lady of Perpetual Help (“Parish”), a part of the Archdiocese, this “Annual Permission Form & General Release: Religious Formation & Youth Activities (“Permission Form”) has been provided to assist the Archdiocese in serving the Participant and the Parent. This Permission Form is effective as of the date indicated (“Effective Date”) with a term of twelve consecutive months or until a new permission form or equivalent is executed (“Term”).
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- Name of Activity REQUIRED Please fill out this field. Please enter valid data.
- Date(s) of Activity REQUIRED Please fill out this field. Please enter valid data.
- Participant's Name REQUIRED Please fill out this field. Please enter valid data.
- Participant's Birth Date REQUIRED Please fill out this field. Please enter valid data.
- Participant's Age REQUIRED Please fill out this field. Please enter valid data.
- Participant's Gender REQUIRED Please fill out this field.
- Participant's Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Participant resides with: REQUIRED Please fill out this field.
- Mother's Name REQUIRED Please fill out this field. Please enter valid data.
- Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Mother's Address (if different that Participant's address) Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Father's Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Father's Address (if different from Participant's address) Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Emergency Contact Other than Parents/Guardian(s) REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Emergency Contact Other than Parents/Guardian(s) REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- 1. Permission: The Parent, as the custodial parent and/or legal guardian of the Participant, grants permission for the Participant to partake in the Activities to be held at the Parish for the Term. Parent understands these Activities are held on a routine basis to be determined by the Parish. The Parish may provide more information on the specific details of the Activities available.
  Acknowledgment of Statement Please select this field.
- 2. Emergency Medical Care: The Parent hereby certifies that, to the best of his or her knowledge, the Participant is physically able to participate in the Activities. If the situation arises that the Participant is in need of immediate emergency care, in the sole discretion of the Parish, the Parent consents to the Participant receiving emergency medical treatment. The Parent accepts full responsibility for any and all costs associated with the medical care of the Participant. If the Parent is aware of any medical conditions, e.g., food or other allergies, adverse reactions, disabilities, or other condition of the Participant that the Parent believes should be disclosed to the Parish in order to care for the Participant while entrusted into parochial care, the Parent may list and explain as follows:
  Acknowledgment of Statement Please select this field.
- List any medical conditions, e.g., food or other allergies, adverse reactions, disabilities, or other condition
- 3. Media Release: The Parent understands that the Activities may be photographed, videotaped, or recorded and hereby grants permission to the Archdiocese to use the image and likeness of the Participant, in the sole discretion of the Archdiocese, in any and all archdiocesan media. Parties agree that compensation for the image and likeness of the Participant is limited to the adequate and valuable consideration described herein. Certain events, e.g., the Holy Mass and other large-scale events, should be considered public events.
  Acknowledgment of Statement Please select this field.
- 4. Waiver and Release: Parent hereby releases, forever discharges, and agrees to hold harmless the Archdiocese, including its successors, assigns, affiliates, directors, officers, employees, and agents, from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from any matter related to the Participant engaging in or otherwise participating in the Activities, except to the extent arising out of the gross negligence or intentional misconduct of the Archdiocese. Parent acknowledges and understands that Parent is releasing the Archdiocese from any and all liability for injury, illness, death, or property damage resulting from any matter related to the Participant engaging in the Activities to the fullest extent permitted by Oklahoma law.
  Acknowledgment of Statement Please select this field.
- 5. Assumption of Risk: Parents hereby acknowledge the risks, including all risks associated with personal property and potentially highrisk activities, e.g., sports, of having the Participant involved in any way the Activities and hereby expressly assumes all risk of lost, stolen, or damaged property and injury, illness, and harm associated with the Participant engaging in the Activities.
  Acknowledgment of Statement Please select this field.
- 6. Minors: Parent hereby agrees and understands that all provisions of this Permission Form, including but not limited to, Section 4 and Section 5 of this Permission Form, are also made on behalf of the Participant, a minor, entrusted to their care, to the fullest extent permitted by Oklahoma law. Parent agrees to help assist, explain, and stress the importance of any rules, guidelines, or behavioral standards of the Parish to the Participant, as age appropriate. In addition to any parochial policy, the Archdiocese does not permit the Participant to (a) possess, obtain, use, or abuse alcohol, tobacco, or any other illegal substances; or (b) possess, obtain, or use a weapon of any kind, including pocketknives. Parent understands that violation of either parochial or archdiocesan standards may result in discipline including and up to being prohibited from attending or otherwise engaging in Activities.
  Acknowledgment of Statement Please select this field.
- 7. General Provisions: This Permission Form contains the entire agreement and understanding between the Archdiocese and the Parent and supersedes all prior and contemporaneous agreements and understandings. The provisions of this Permission Form are independent of and severable from each other, and no provision will be affected or rendered invalid or unenforceable by virtue of the fact that for any reason any other or others of them may be invalid or unenforceable in whole or in part. This Permission Form is governed by the laws of the State of Oklahoma. Parent agrees, in the event of a dispute regarding this Permission Form, venue is proper in a Court of competent jurisdiction in Oklahoma County, Oklahoma, and Parent waives any objection to such venue. The paragraph or section headings herein are for convenience only and do not define, limit, or construe any contents of such paragraphs or sections. The Archdiocese is an Oklahoma not for profit corporation sole.
  Acknowledgment of Statement Please select this field.
- As a rule, medication will not be administered by Religious Education/Youth Program staff. The exception is an Religious Education/Youth program or activity that includes an extended day or overnight activity. If medication is required a Consent and Waiver Medication Form must be completed prior to the activity.
  
  I certify to you that the information contained herein is true and correct to the best of my knowledge and that I fully understand the terms and legal consequences of my execution of this ANNUAL PERMISSION FORM & GENERAL RELEASE FOR MINORS: RELIGIOUS FORMATION & ACTIVITIES
  
  I understand that checking box below constitutes that the below is a legal signature, all the above information is true and that I acknowledge and agree to the permission being asked for in this form.
  Acknowledgement of Statement Please select this field.
- Custodial Parent/Guardian Signature REQUIRED Please fill out this field. Please enter valid data.
- Date Signed (“Effective Date”) REQUIRED Please fill out this field. Please enter valid data.
- Email for Receipt REQUIRED Please fill out this field. Please enter an email address.
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