Medical and Photo Releases
This form covers all on-site events at Saint Benedict Catholic Church and Saint Benedict Catholic School events taking place between August 2026 - July 2027. Updates, inclement weather cancelations, and additional correspondence will be done by email. There may be events that require an additional liability form.
Medical Release
As parent and/or legal guardian I remain legally responsible for any personal actions taken by the above named minor. I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Benedict Catholic Church the Catholic Diocese of Richmond, its employees and agents, chaperones, or representatives associated with this event from any claim arising from or in connection with my child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate the Diocese, its employees and agents and chaperones, or representatives associated with the event for reasonable attorney’s fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the Diocese.
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. In the event of any 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 above numbers I give permission for the noted emergency contact to be notified. I will not hold St. Benedict Catholic Church and the Diocese of Richmond responsible for authorizing any medical treatment beyond necessary transportation to the hospital.
Please contact Ben Fleser with any questions.
Use of Pictures/Videos
Pictures of your child participating in activities related to the parish or diocesan events may be posted through St. Benedict Catholic Church and/or Diocese of Richmond publications or websites. Names of participants will not be used without expressed permission from the parent or guardian. If you do not want your child’s picture to be used for publications please submit an email to Ben Fleser at bfleser@saintbenedictparish.org.