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A Day in the Life of a Jester (2018)

Friday, November 16, 2018, at Saint Joseph High School

Please complete the following registration form. Required fields are marked with an asterisk (*):

Current Grade*
Address
State*

I request that my daughter be permitted to participate is A Day in the Life of a Jester at Saint Joseph High School. My daughter has no medical condition that would render it inappropriate for her to participate.

Should it be necessary for my daughter to take medication while participating in this activity, I hereby give my daughter permission to self-administer her medication in accordance with the Medication Authorization and Permission Form on file at my grammar school and attached (a copy must be uploaded with this registration form or be brought to SJHS on the day of the event), and, if my daughter cannot self-administer, I give permission to the responsible SJHS staff members to administer or to assist in the administration of my daughter’s medication.

My daughter will need to take medication*
Please upload copy of Medication Authorization form here:
or drag it here.

I also give permission to the responsible staff members, chaperones, medical practitioners and medical facilities to use their judgment in obtaining and providing medical treatment for my daughter should it become necessary to do so. I agree to relieve Saint Joseph High School and participating adults from liability in connection with this request. I understand that the insurance benefits through Saint Joseph High School, if any, may have limited application, and that I am entirely responsible for the cost of all medical treatment provided to my daughter. I agree to indemnify and hold Saint Joseph High School harmless from the cost of any medical treatment and related expense and cost incurred.

Release of Liability: As a condition of participating in this activity, I hereby hold harmless, release and discharge The Roman Catholic Archbishop of Los Angeles, a corporation sole, Archdiocese of Los Angeles Education & Welfare Corporation and Saint Joseph High School, their respective agents and employees and any parent/volunteer/chaperone, from any and all liability, loss or claims for personal injuries, wrongful death or property damage that I or my daughter may suffer as a result of participation in the activity described above.

Permission to use images: I hereby authorize Saint Joseph High School to use images that may include my daughter for marketing and development purposes (examples: Website, Facebook)

By typing your name and today’s date below, you are verifying that you are the parent/guardian, that you agree to the statements above, and you are permitting your daughter to participate in the 2018 Day in the Life of a Jester event.

Confirmation Email