Summer Camp Registration

General Instructions to Parents/Guardians: 1. Please take care in filling out this form. It provides crucial information for caregivers in the event of illness or medical emergency. Accuracy and thoroughness are encouraged. 2. Sections I, II, and V are mandatory. Sections III and IV provide you with treatment options in non- emergency situations.

Indicate which camps you intend to purchase registrations for today. This does not automatically add them to the shopping cart, so please double check when adding camps to the cart!

SECTION I: MEDICAL MATTERS As the parent/legal guardian of the above-named child, who is currently associated with (school/church/parish) St. Scholastica Academy, I hereby authorize CYO/Youth & Young Adult Ministry Office, the Parish, and/or the School or their assistants to carry out the authorizations I have delineated in areas of emergency medical treatment and other cases of illness. These authorizations inclusively extend from the following dates: May 27th, 2025 through July 25th, 2025. I hereby warrant that, to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. I agree on behalf of myself, my child named herein, and my spouse, our heirs, successors, and assigns, to indemnify, hold harmless, and defend the CYO/Youth & Adult Ministry Office, the Parish, and/or the School, and The Roman Catholic Church of the Archdiocese of New Orleans, their members, directors, officers, employees, agents, and representatives from or in connection with any and all liability and/or damages (including but not limited to physical, mental, emotional and/or economic damages) that may be sustained arising from negligence, fault, or strict liability related to facilitating or administering the medical treatment agreed to herein.

SECTION II: EMERGENCY MEDICAL TREATMENT In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, if you are unable to reach me at the numbers listed herein, please contact:

SECTION III: OTHER MEDICAL TREATMENT (OPTIONAL. SIGN ONLY IF YOU WANT TO BE NOTIFIED IN THE FOLLOWING INSTANCES) In the event it comes to the attention of the CYO, the parish, the school, or their agents or representatives that my child becomes ill with symptoms such as headache, vomiting, sore throat, fever, diarrhea, I want to be called.

SECTION IV: MEDICATIONS (SIGN ONLY THOSE OPTIONS THAT ARE APPLICABLE)

OPTION 1: My child is taking medication at present. My child will bring all such medications necessary, and such medications will be well-labeled. Names of medications and concise directions for seeing that the child takes such medications, including dosage and frequency of dosage, are as follows:

OPTION 2: I hereby grant permission for non-prescription medication (such as aspirin, throat lozenges, cough syrup) to be given to my child, if deemed appropriate.

OPTION 3: NO medication of any type, whether prescription or non-prescription, may be administered to my child unless the situation is life-threatening and emergency treatment is required.

SECTION V: MEDICAL INFORMATION The CYO or parish orschool will take reasonable care to see that the following information will be held in confidence.

As parent and/or legal guardian, I remain legally responsible for any actions of the above-named minor (“participant”). 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 agree on behalf of myself, my child named herein, and my spouse, our heirs, successors, and assigns, to indemnify, hold harmless, and defend the CYO/Youth & Young Adult Ministry Office, the parish and/or school St. Scholastica Academy and The Roman Catholic Church of the Archdiocese of New Orleans, their members, directors, officers, employees, agents and representatives associated with the event from any and all liability claims, loss or damage arising from or in connection with the negligent or intentional acts of my child or third parties.