I authorize that appropriate pictures of my child(ren) may be taken during activities. I hereby grant the use of and release to the Catholic Diocese of Phoenix and Blessed Sacrament Roman Catholic Parish the use of my child(ren)’s name or likeness, whether in still, motion pictures, audio and videotape, my child(ren)’s photograph and/or other reproduction of him/her including his/her voice and features with or without his/her name for any promotional purposes involving the diocese or parish/school, news or feature stories in The Catholic Sun or other media. These items may be used without limitation or reservation of any fee.

I request that the above-named participant be allowed to attend the Blessed Sacrament Life Teen Program at Blessed Sacrament and the Life Teen Kick-off at Octane Entertainment. Families are responsible for all transportation.

In the event of an illness or injury, I request that the designated volunteer or Coordinator of Youth and Young Adult Ministries obtain medical treatment on my behalf for my student if I or the emergency contact cannot be reached. Prescription medication will be given in its original container with dosage information on it. I understand reasonable precautions will be taken to safeguard the health and well-being of my child and that I will be contacted immediately in case of an emergency or accident. I will not hold the Parish, Diocese of Phoenix, the Chaperone, or Coordinator of Youth and Young Adult Ministries responsible for accident or injury.