Participant’s Name: _________________________________________

Parent/Guardian’s Name: _____________________________________

Home Address: _____________________________________________

Home Phone: ________________ Business Phone: ____________

I grant permission for my child __________________________________ to participate in this parish event that requires transportation to a location away from the parish site. This activity will take place under the guidance and direction of Confirmation volunteers from Sacred Heart.

Type of event: Lock-In

Date and estimated length of event: May 21, 2010 (5:30pm) - May 22, 2010 (12:00pm)

Transportation: Val Lindeman

Destination of event: Meet up at Pizza Hut at 5:30pm

Individual in charge: Scott Gunnell and Val Lindeman

**PLEASE RSVP!!!!  Valerie Lindeman    907-841-4474  (Call or Text)**

Agenda:

PIZZA:

Meet at Pizza Hut at 5:30pm May 21, 2010

SWIM:

Walk to Wasilla Pool

MOVIE:

Walk to Sacred Heart

LOCK-IN:

Girls will sleep in the Church                 

Boys will sleep in the St. Jude Center

*Morning activities until Noon*

ITEMS TO BRING:

*Sleeping Bag                 *Toiletries

*Pillow                              * Permission Slip

*Swim Suite, etc             

**GOOD ATTITUDE**

As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor (participant)

I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend Sacred Heart Parish, its officers, directors and agents; and the Anchorage Archdiocesan chaperones or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish, Its officers, directors and agents and the Anchorage Archdiocesan, chaperone or representative associated with the event for reasonable attorney’s fees and expenses arising in connection therewith.

Signature: _____________________________ Date: ________________