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Mass: Sa 4PM, Su 8 & 10:30AM

Child Care Permission Form

Child Care Parent/Legal Guardian Indemnity Agreement
  • Designated Supervisor of Activity: Christ King Childcare Workers
    Activity: Marriage Ministry Child Care
    Dates of Activity: All Marriage Ministry Events in 2022 
  • I consent to the participation of my child(ren) in the above-named activity. In consideration for my child(ren)’s participation, I agree to reimburse and indemnify the parish/school (understood to include the Archdiocese of Milwaukee) for all reasonable legal and court fees incurred by parish/school in defending a lawsuit that I or my child(ren) may bring against the parish/school which relates to the above-named activity if the parish/school is found not legally liable by the courts and prevails in the lawsuit.  If the parish/school is found legally liable for injuries sustained by the child(ren), this paragraph will not apply.
     
    I certify that I understand this agreement and any risks and/or hazards associated with the activity described above that my child(ren) will be participating in. I further understand that I received the opportunity to fully discuss this agreement with a representative of the parish/school to clarify any concerns or questions about the activity or this agreement that I may have had. 

  • EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I give permission for Christ King’s Child Care to make arrangements to transport my child to a hospital for emergency medical 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 above numbers, contact: 


  • Please furnish medical information about your child(ren) which may be pertinent to his/her participation in the above identified activity, including medications and allergies: 


  • By checking the "I agree" box below, I adopt the content of this form and wish to communicate such information and consent electronically to my parish as it represents my signature as the parent or legal guardian.

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    This form has been prepared by and is required by The Archdiocese of Milwaukee’s Protected Self-Insurance Program. Questions should be directed to Catholic Mutual Group at (262) 255-6906. 
     

    IMPORTANT NOTES FOR PARENTS
     
    You may bring snacks/dinner for your child, provided they are nut-free. Please disclose any allergies in the form above so we can provide a safe environment for your child. 
     
    If your child is under the age of four, we require you to bring a change of clothes and a pull-up to every session. Accidents happen, even after potty training!

     
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