Join us for our Live Stream Sunday Mass at 9am

Teen Permission Form 2020

Teen Permission Trip Form 2020

  • Emergency Contact Name and Phone Number, if unable to reach parent:

  • Please list if applicable.
  • PERMISSION & AUTHORIZATION FORM FOR MEDICAL TREATMENT

  • I/We, the parent(s)request that Holy Family Teen Faith program allow my/our child to participate in Catholic Heart WorkCamp Summer Mission Trip in Farmington, MI June 21-26, 2020 I hereby release and indemnify Holy Family Parish, its staff and its volunteers and the Catholic Bishop of Chicago, a corporation sole, from any and all liability arising from claims of any kind or nature whatsoever from my child’s participation in this event. In the event that the undersigned or my (our) authorized physician, cannot be reached, and in the judgment of a responsible person accompanying the group, or other appropriate staff member, there is a necessity for immediate examination and/or treatment of my (our) child, I/We hereby authorize any of the aforesaid people to obtain for my child such medical services as are deemed necessary.

  • MM slash DD slash YYYY
  • I have read and understand the rules and agree to comply with them.

  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

This website uses cookies to ensure you get the best experience on our website.