Visitation Parish
Catholic Church

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Permission Form

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  On DATE the children will be attending ACTIVITY.
  It will begin at START TIME and end by END TIME and will be held on the Parish/School campus.
  
  Please list any allergies your child may have: Please enter valid data.
  
  Please complete and sign the below permission slip and waiver by DATE if your child(ren) will be attending.
  
  I hereby release and indemnify Visitation Parish, IL its staff, and volunteers from any and all liability arising from claims of any kind or nature whatsoever from my child's participation in this event.
  
  RELEASE: If EMERGENCY treatment is required, and the parents or legal guardian cannot be reached immediately, your signature in the space provided below empowers the school authorities to exercise their judgement to transport the child to a hospital emergency room.
  
  The parties agree that this document may be electronically signed and that the electronic signature appearing on this document is the same as handwritten signatures for the purpose of validity, enforceability and admissibility.
  
  Signature of Parent or Guardian: REQUIRED Please fill out this field. Please enter valid data.
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  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.
  
  Phone Number where I can be reached during the event: REQUIRED Please fill out this field. Please enter valid data.
  
  Submit