I hereby consent to participation by my child named below, in the St. Henry & St. Bernard Youth Groups Underground Church Activity.  I understand that my child will be under the supervision of the designated parish employee on the stated date(s).  I further consent to the conditions stated in the event description, participation in said event, including the method of transportation (if applicable).

As parent/legal guardian you remain fully responsible for any legal outcome which may result from any personal actions taken by your child.  Your signature fully releases the parishes of St. Bernard and St. Henry, its pastors, its Director of Evangelization & Catechesis, Coordinator of Relgious Education, the Diocese of Madison and its Bishop from any and all liability..

Parents Name: (printed if form is not electronically submitted.)

Parents Signature: (if not electronically filed, sign. If completing electronically, your name entered here constitutes legal substitution for your legal signature.)

Date: (d/m/yyyy)