Teens in Christ
St. John the Baptist Youth Group
Diocese of Orlando Field Trip Permission Form and Release of Liability
I am the parent/guardian of ___________________________, and give my permission for my child to travel in Privately owned vehicle to attend the above listed event on ______________. I acknowledge that St. John the Baptist Catholic Church is responsible for transportation only from the designated place of departure (church parking lot) to the event and back again at the designated time and place of arrival. My child must also comply with the attached Diocese of Orlando Code of Conduct. By granting this permission, I also wave any claims against, and release and hold harmless, St. John the Baptist Catholic Church, the Diocese of Orlando, and any of their religious, employees, volunteers, agents and representatives, from any harm that occurs to my child while participating in this event.
In the event my child requires medical treatment or transportation for medical care, St. John the Baptist Catholic Church of Dunnellon, FL will attempt to contact me at the number(s) listed below. If the chaperones, volunteers, or other adult supervisors are unable to reach the designated emergency contact, I authorize them to take appropriate measures to provide care and treatment for my child, to transport my chold to the nearest first aid center, emergency room or physician’s office, or to call an emergency paramedic ambulance service.
_______________________________________ _______________________________
Parent/Guardian’s Signature Date
______________________________________ ________________________________
Parent/Guardian (PRINT NAME) Emergency Contact (PRINT NAME)
Phone Numbers Phone Numbers
Home: Home:
Cell: Cell:
Work: Work:
Please continue with medical information
Diocese of Orlando-Code of Behavior
Parent's Signature:
We welcome you to this youth event and hope that you will enjoy your time. We expect you to project an image of Christian consideration, sensitivity, and respect to everyone and to the property around you. We are confident you will display the maturity, responsible leadership and character that have become the trademark qualities of Catholic youth. We also expect the same from guests who have joined us on this trip. With this in mind, we offer you the following Code of Behavior so that everyone might have a terrific experience. Thank you!
In General
Parish group leaders are responsible for the actions of the members of their group. All adults are to help enforce the Code of Behavior (the Code) and to set an example for all youth participants.
Some Rules
1. The Diocese of Orlando does not tolerate the possession of weapons of any kind. Failure to comply with this rule will result in immediate dismissal from the event at the expense of the parent and child.
2. The use of alcohol and drugs is strictly prohibited. The Diocese of Orlando does not tolerate the purchase, possession or consumption of beer, wine or other alcoholic beverages by minors (or for minors) and the possession or use of illegal drugs by any individual. Failure to comply with this rule will result in immediate dismissal from event at the expense of parent and child.
3. Smoking is not permitted at any St. John the Baptist Youth Group event. Failure to comply with this rule could result in dismissal from event.
4. Participants must be attend and be on time for all scheduled activities (example: meet for lunch, check in times, leaving time, etc.)
5. You participants are to recognize that any adult chaperone may exercise the authority to enforce the Code. Disrespect toward any chaperone exercising appropriate means to enforce the Code could result in dismissal from the event and will hinder future participation in SJB Youth events.
6. We are guests at the event facility. Be mindful of the environment and deposit all waste/garbage in the appropriate receptacles.
7. If there is a disciplinary problem or any of the Code is not followed, the teen will be prohibited from attending future events.
—————————————————————- ———————————————————-
Signature of Youth Participant (Print Name/date)