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 16th, 2024, during the times of 2 p.m. to 5 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 Boys’ Basketball 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.

Serra Catholic Boys Basketball Summer Clinic - 2024 Application