Individuals who have graduated 12th grade and are under 21 years old should also utilize this form. If you have any concerns regarding this please contact Antoinette.
Parent/Legal Guardian Information
Liability Waiver and Medical Release:
I give permission for my child to participate in this mission trip that requires transportation to a location away from the parish, school and Diocese. This activity will take place under the guidance and direction of parish employees and/or volunteers from St. Matthew Catholic Church. As parent and/or legal guardian, not St. Matthew Catholic Church, Diocese of Nashville, or those acting as chaperones, retain full legal, physical, and financial responsibility for my child’s personal actions. I agree on behalf of myself, my heirs, assigns, executors, and personal representatives, to hold harmless and defend St. Matthew Catholic Church, Diocese of Nashville, its officers, directors, agents, employees, volunteers, or representatives associated with this mission trip from any and all liability claims, loss or damage arising from or in connection with my child’s participation in this mission trip. In the event of an emergency, I give permission for any medical treatment deemed necessary by the Saint Matthew staff. I also give permission to transport my child to any reasonably accessible hospital or physician’s office. I remain financially responsible for my child’s medical treatment.
By typing my name here, I signify that I am the parent or legal guardian of the student and I agree to the release/ medical waiver detailed above.
Media Waiver Release:
I give consent for my child to be in photos and videos used to promote the Diocese of Nashville, Saint Matthew Catholic Church, and Catholic faith leaders. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me because of such use.
By typing my name here, I signify that I am the parent or legal gaurdian of the participant and I agree to the media release detailed above.
