Saturday, January 114:00 p.m. - midnight
At St. Joseph's Catholic Church
  
 
Parental/Guardian Consent Form and Liability Waiver
I,
grant permission for my child,
to participate in the event, sponsored by St. Joseph. This activity will take place under the guidance and direction of parish employees and volunteers from St. Joseph.

Type of event: Middle School Lock-In
Location of the event: St. Joseph's Catholic Church
Individuals in charge: Melissa Hund-Cerna
Date of event: Saturday, January 11, 4:00 p.m. - midnight
Registration due: Wednesday November 20. 
Cost of Event: $10.00

As a parent and/or guardian, I remain legally responsible for any personal actions taken by the above named minor (participant). I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Joseph’s, its officers, directors and agents, chaperones, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate St. Joseph’s, its officers, directors and agents, chaperones, or representatives associated with the event for reasonable attorney’s fee and expenses arising in connection therewith.
Parent Signature *
clear
 +