Home
About
Pastor's Corner
Mass Times
Our Staff
Bulletins
Contact Us
Join Us
Online Giving
Faith Formation
Religious Education
Sunday Religious Education Classes
Adult Faith Formation
COVID-form
Sacraments
Sacraments of Initiation
Baptism
Confirmation
RCIA/RCIC
Sacraments of Healing
Anointing of the Sick
First Reconciliation & First Eucharist
Sacraments of Service
Matrimony
Ministries
Committees
Liturgy/Church
Music
Youth
Knights of Columbus
Devotional
Services
The Lighter Side
Events & News
Events & News
Calendar
News
Photo Albums
Resources
Daily Mass
Catholic Prayers
Basic Prayers
Prayer to Jesus
Marian Prayers
Prayers of the Saints
Other Prayers
Catholic Websites
Year of the Eucharist & the Parish
Pastor's Posts
|||
Bulletins
Contact Us
Online Giving
Facebook
Email
YouTube
Search
Search
Home
About
Pastor's Corner
Mass Times
Our Staff
Bulletins
Contact Us
Join Us
Online Giving
Faith Formation
Religious Education
Sacraments
Sacraments of Initiation
Baptism
Confirmation
RCIA/RCIC
Sacraments of Healing
Anointing of the Sick
First Reconciliation & First Eucharist
Sacraments of Service
Matrimony
Ministries
Committees
Liturgy/Church
Music
Youth
Knights of Columbus
Devotional
Services
The Lighter Side
Events & News
Events & News
Calendar
News
Photo Albums
Resources
Daily Mass
Catholic Prayers
Catholic Websites
Year of the Eucharist & the Parish
Pastor's Posts
Covid-19 Liability waiver & consent form
The maximum number of form submissions has been reached. This form is currently not available.
ARCHDIOCESE OF MOBILE PARENTAL/GUARDIAN COVID-19 CONSENT FORM AND LIABILITY WAIVER
Participant Info
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Sex
REQUIRED
(Select One)
Male
Female
Please fill out this field.
Parent/Guardian
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Street Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Email
REQUIRED
Please fill out this field.
Please enter an email address.
Home Phone Number
REQUIRED
Please fill out this field.
Please enter a phone number.
Business or Cell Phone Number
REQUIRED
Please fill out this field.
Please enter a phone number.
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and as a result, social distancing is recommended.
Our Savior Parish/School
will follow state and local standards of conduct and has put in place reasonable preventative measures to reduce the spread of COVID-19 at its
Our Savior Parish/School
activity (including but not limited to summer camp). However, even though such standards will be followed and reasonable measures put into place,
Our Savior Parish/School
cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the
Our Savior Parish/School
activity could increase your risk and your child(ren)’s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and I may be exposed to or infected by COVID-19 by participating in the
Our Savior Parish/School
activity and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at
Our Savior Parish/School
may result from the actions, omissions, or negligence of myself and others, including, but not limited to,
Our Savior Parish/School
employees, volunteers, and program participants and their families.
Considering the foregoing, however, I,
First Name
Last Name
, grant permission for my child,
First Name
Last Name
, to participate in this parish activity that may require transportation to a location away from the parish site, notwithstanding the risks associated with the COVID-19 virus and group activities.
I confirm that there are no necessary changes to the Medical Information Consent form for my child that I previously submitted. If there are any necessary changes, I will complete another Medical Information Consent form.
I further agree on behalf of myself, my child named herein, and my spouse, our heirs, successors, and assigns, to release, indemnify, and hold harmless
Our Savior Parish/School
and The Roman Catholic Church of the Archdiocese of Mobile, their members, directors, officers, employees, agents and representatives (“Indemnitees”) associated with the event arising from or in connection with the negligent acts or omissions of the Indemnitees ONLY in regard to prevention of the spread of the COVID-19 virus. I SPECIFICALLY ACKNOWLEDGE AND AGREE TO THE FOREGOING.
By checking this box and entering my FULL NAME below, I agree to the above statement of consent and waiver of liability.
REQUIRED
I agree.
Please fill out this field.
Enter FULL NAME Here (Parent/Guardian)
REQUIRED
Please fill out this field.
Please enter valid data.
Submit
This site is protected by reCAPTCHA and the Google
Privacy Policy
and
Terms of Service
apply.