S4C is a 4-day, 4-night service retreat for high school teens, young adults, and adult chaperones, planned and lead by youth ministers from Immaculate Heart of Mary, Cuyahoga Falls; St. Barnabas, Northfield; St. Basil the Great, Brecksville; St. Hilary, Fairlawn; and St. Mary, Hudson. Three days of service to members of local communities will be followed each evening by a dynamic retreat experience and sleepover. The fourth day will be a fun day. Adult and young adult group leaders will be teamed together to guide a group of 4-8 teens.
Waiver of Liability and Photo Consent: I
Waiver of Liability and Photo Consent: Iam hereby granting permission for the named student to participate in Servants 4 Christ retreat at Immaculate Heart of Mary Church in Cuyahoga Falls.
I hereby acknowledge that the above-named child will travel to & from activities in transportation provided by the staff & volunteers of Immaculate Heart of Mary, St. Barnabas, St. Basil, St. Hilary, and St. Mary. I understand that the vehicle being used to transport the above-named child will leave from & return to Immaculate Heart of Mary. I agree to come to pick up the above-named child at the request of the staff or volunteers of Servants 4 Christ if he/she is not abiding by the rules governing the activity.
I fully understand what is involved in the activity, and understand that I can call the youth minister of any involved parishes and ask them about the activity. Therefore, by my signature, on behalf of my child, my spouse, and myself, I hereby assume all risks in connection with this activity and I further release, discharge, and/or otherwise indemnify Immaculate Heart of Mary, St. Barnabas, St. Basil, St. Hilary, and St. Mary, any and all supervisors, employees, organizers, sponsors or volunteers associated with the event, the Bishop of Cleveland, and the Roman Catholic Diocese of Cleveland from any and all claims, judgments and liability by or on behalf of my child, myself, my spouse, and/or any assigns for any foreseen or unforeseen injury or damage, medical bills, hospital bills, or doctor bills the above-named child or his/her estate incurred as a result of participation in this activity.
I hereby give consent to photograph or videotape my son/daughter and without limitation to use such photographs or videotapes and/or stories in connection with Servants 4 Christ without consideration of any kind, and I do hereby release Immaculate Heart of Mary, St. Barnabas, St. Basil, St. Hilary, and St. Mary from any claims whatsoever which may arise in said regard.
AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT: In the event reasonable attempts to contact me, have been unsuccessful, I, as the parent or legal guardian of the above-named child do hereby give my consent for Immaculate Heart of Mary, St. Barnabas, St. Basil, St. Hilary, and St. Mary, or other adult representatives (1) to seek medical attention and treatment deemed necessary preferred physician, preferred dentist or in the event the designated preferred physician is not available, by another licensed physician or dentist; and (2) I give permission to transfer my child to preferred hospital or any hospital reasonably accessible. This authorization does not cover major surgery, unless the medical opinion of two other licensed physicians or dentists concur on the necessity for such surgery and are obtained before surgery is performed.