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Serra Catholic Girls Soccer Summer Clinic 2025

Serra Catholic Girls Soccer Summer Clinic 2025

July 9, 2025 from 6 to 8 p.m.

Name*

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Street Address*

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City*

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Zip/Postal*

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Parent or Guardian*

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Phone Number*

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Age*

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School*

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I grant Serra Catholic High School permission to use photographs of my child participating in this camp on the Serra Catholic and/or team social media and/or website.*

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Yes

I/We, the undersigned Parent(s) or Guardian of the above child, do hereby give my/our permission for my/our child to participate in the Summer Day Camp sponsored by Serra Catholic High School at Serra Catholic High School on July 9th, 2025 during the times of 6 p.m. to 8 p.m.

HOLD HARMLESS AND INDEMNIFICATION

In consideration of the agreement of Serra Catholic High School to allow my child to participate in said outing, and INTENDING TO BE LEGALLY BOUND HEREBY, I agree to indemnify and hold harmless Serra Catholic High School Girls' Soccer team, coaches, and staff, the Roman Catholic Diocese of Pittsburgh, Bishop Zubik, Principal Bob Childs and their successors and legal representatives, against any loss from any and all claims, demands and actions at law or in equity that may hereafter at any time be brought by my child or anyone acting on his/her behalf, for the purpose of enforcing a claim for damages because of any injury (including death) to my child as a result of or in any way related to his/her participation in the above-mentioned activity, or his/her transit thereto. I/We, agree that in case of injury to my/our child, I will apply our hospitalization and/or accident insurance toward the payment of the expenses incurred and will not look to Serra Catholic high School or the Roman Catholic Diocese of Pittsburgh for the payment of any medical costs or injury related costs.

MEDICAL AUTHORIZATION

In the event of injury or illness to our child during the above trip, we hereby give our permission for the necessary medical treatment to be given to our child. We further authorize the representative of Serra Catholic High School who accompanies our child on said camp to act on our behalf in signing consents, releases or other document or hospitals forms in the event of illness or of injury to our child in order that medical or hospital care can be obtained, with the same power and authority as if we were present to act. We, for ourselves, for our child, our respective heirs, and our respective legal representatives, do hereby release any representative of Serra Catholic High School from any and all claims, demands, and causes of action of whatever kind and nature for their actions taken pursuant to this authority.

IN WITNESS WHEREOF, I/We execute this Hold Harmless and Indemnification Agreement on the date indicated with the signature.

I acknowledge that I've read the above Hold Harmless and Indemnification and Medical Authorization.*

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Yes

Signature*

Signature Required

Email Address*

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Summer Clinic Fee*

Price: $25.00

Confirmation Email

Confirmation Email *

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