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Travel Liability Form

- Community

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- CONSENT TO PARTICIPATE AND LIABILITY RELEASE
  
  In consideration for allowing me to participate in this activity, I assume all risks and hazards incidental to my participation in the Event, including transportation to and from the Event. In consideration for allowing me to participate in the event listed above, and on behalf of myself and my parents, legal guardians, siblings, heirs, assigns, and personal representatives, I hereby release and agree to fully and unconditionally protect, indemnify, and defend the Parish, the Roman Catholic Diocese of Dallas, and their respective officers, agents, and employees, (collectively, “Indemnitees”) and hold each Indemnitee harmless from and against any and all costs, expenses, attorney’s fees, claims damages, demands, suits, judgments, losses, or liability for injuries to property, injuries to persons, and from any other costs, expenses, attorney fees, claims, suits judgments, losses, or liabilities of any and every nature whatsoever arising in any manner, directly or indirectly, out of, in connection with, in the course of, or incidental to my participation in the Event, REGARDLESS OF CAUSE OR OF THE JOINT, COMPARATIVE OR CONCURRENT NEGLIGENCE OF THE INDEMNITEES. In the event any legal action is taken by either party against the other party to enforce any of the terms and conditions of this release, it is agreed that the unsuccessful party to such action shall pay to the prevailing party therein all reasonable court costs, attorneys’ fees, and expenses incurred by the prevailing party.
  
  AUDIO/VISUAL RECORDING AND PHOTOGRAPHY CONSENT
  
  On occasion, video recordings, audio recordings, photographic slides, and photographs are taken during church and diocesan sponsored activities. These are utilized in newsletters, websites, event promotion, advertisements and other printed media. I hereby release and agree to fully and unconditionally protect, indemnify, and defend St. Patrick Parish, the Roman Catholic Diocese of Dallas, and their respective officers, agents, and employees, (collectively, “Indemnitees”) and hold each Indemnitee harmless from and against any and all costs, expenses, attorney’s fees, claims damages, demands, suits, judgments, losses, or liability for injuries to property, injuries to persons (including Student) and from any other costs, expenses, attorney fees, claims, suits judgments, losses, or liabilities of any and every nature whatsoever arising in any manner, directly or indirectly, out of, in connection with, in the course of, or incidental to the use or publication of any photographs, videos, or other images of me, REGARDLESS OF CAUSE OR OF THE JOINT, COMPARATIVE, OR CONCURRENT NEGLIGENCE OF THE INDEMNITEES.
  
  This form must be filled out per participant for each trip the parish makes.
- Event REQUIRED Please fill out this field.
- Participant's Name REQUIRED Please fill out this field. Please enter valid data.
- Guardian Name (If participant is under the age of 18) Please enter valid data.
- 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. Please enter valid data.
- Zip REQUIRED Please fill out this field. Please enter valid data.
- Primary Phone REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact's Phone REQUIRED Please fill out this field. Please enter valid data.
- Primary Care Physician Please enter valid data.
- Primary Care Physician's Phone Please enter valid data.
- I agree to acknowledge and I understand the policy concerning liability release. I also understand that by clicking this and the submit button, for myself or as a guardian, I am signing the form electronically.
  I Agree Please select this field.
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St. Patrick Catholic Church

Denison, Texas

Travel Liability Form