HS Team Builder Permission Slip Please fill this out by 9/29/24 to participate in the SNL Team Builder! Please Fill Out By Sept. 29, 2024Your child is eligible to participate in a St. Pius X Parish sponsored activity requiring transportation to a location away from the parish premises. This activity will take place under the guidance and supervision of chaperones from St. Pius X. A brief description of the activity follows: Name of event: High School Team Builder Time of Event: 7:00-9:00pm Date of Event: Sept. 29, 2024 Transportation: Travel on foot up to 1/2 mile from SPX (with chaperones) As a parent or legal guardian, you remain fully responsible for the actions and conduct of your child. Statement of Consent(Required)I hereby consent to participation by my child in the event scheduled above for Sept. 29, 2024. I understand that the event will take place away from the parish grounds. I further consent to the conditions stated above on participation in this event, including the method of transportation. In consideration of my child being allowed to participate in this event, I agree to waive and release, and indemnify and hold harmless St. Pius X Church, any and all affiliated organizations, its/their employees, agents, representatives, volunteers and drivers, from any and all claims I or my child may have, excluding claims for intentional misconduct or gross negligence, arising from or relating to my child’s participation in this event. I agree.Parent/Guardian Name(Required) First Last Insurance Company & Policy Number(Required)Emergency Contact(Required) First Last Emergency Contact Phone(Required)Teen's Name (1)(Required) First Last Do you have a second teen participating?(Required) Yes No Teen's Name (2)(Required) First Last Do you have a third teen participating?(Required) Yes No Teen's Name (3)(Required) First Last
