I do hereby give my approval for my son/daughter to participate in Box City that is sponsored by Mary Our Queen Catholic Church. I do hereby, for myself, my heirs, executors, and administrators, waive, release, absolve, indemnify and agree to hold harmless any and all adults who chaperone, also the Archdiocese and its representatives, successors, supervisors, sponsors, organizers and participants for any injuries in connection with the program named above. I likewise release from my responsibility any person transporting my child to and from any of the activities.

I hereby grant permission for publication of
group (two or more persons) photos taken at youth events.

I also give permission to seek any emergency care should my child be involved in any accident or be injured in any way during such
events named above. I understand that in any such instance, all attempts will be made to contact the parent/guardian. In the event
that I cannot be contacted, I hereby give permission to the attending physician to hospitalize, secure treatment for, and to order
injection, anesthesia, and/or surgery for my child, as named herein.

I also agree that I am legally responsible for all/any personal actions taken by my child/guardianship during this event, and agree to be financially responsible for any/all damages, legal fees, and other costs incurred as a result of the actions/behavior of my child/guardianship.

Furthermore, I agree that if the above named student’s behavior is inappropriate, unsafe and/or detrimental to the group, I will be
contacted immediately to secure means of removing my child/guardianship from the event premises. I understand that any financial costs
incurred as a result of my child/guardianship being sent home are my responsibility.