Frassati Hike Required Parental Releases Jul 27, 2026 Participant Name First Last Participant Date of Birth Parent/Guardian Name First Last Please select your pick up location 6:00 AM: Corpus Christi (East Sandwich) pickup 7:00 AM: Bishop Connolly (Fall River) pickup 8:00 AM: Bishop Feehan (Attleboro) pickup Parent/Guardian Email Home Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian Cell(Required)Parent/Guardian Home PhoneParent/Guardian Work PhoneParent Guardian Signature(Required)Your NameYour NameYour NameYour NameI, grant permission for this participant to participate in this event. This activity will take place under the guidance and direction of the Diocese of Fall River, Office for Vocations. A brief description of the activity follows: 2026 Frassati Hike for High School Boys Monday, August 3, 2026 Mount Monadnock, Jaffrey, NH All-Day Event As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named participant. I agree on behalf of myself, this participant named herein, or our heirs, successors, and assigns, to hold harmless and defend the Office for Vocations, and the Roman Catholic Bishop of Fall River, Corp Sole, its officers, directors, employees and agents, chaperones, or representatives associated with the event, from any claim arising from or in connection with this participant 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 Office for Vocations, the Roman Catholic Bishop of Fall River, Corp Sole, its officers, directors, employees and agents, 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 parish/school.Today's Date Month Day Year Emergency Contact & Relationshio(Required)Emergency Contact Phone(Required)Family Doctor(Required)Family Doctor Phone(Required)Family Health Plan Carrier(Required)Policy #(Required)Signature - Emergency Medical Treatment(Required)Your NameYour NameYour NameYour NameIn the event of an emergency, I hereby give permission to transport this participant to a hospital for emergency medical or surgical treatment. I wish to be advised by the hospital or doctor prior to any further treatment. In the event of an emergency, if you are unable to reach me at the provided numbers, please contact the emergency contact provided above.Participant MedicationsIf relevant, please list the names of medications and concise directions including dosage and frequency of dosage:Non Prescription Medication Options These medications may be administered to the participant These medications may not be administered to the participant Contact me at the numbers provided before administering This includes non-aspirin products such as ibuprofen or acetaminophen, throat lozenges, cough syrup. Signature - MedicationsYour NameYour NameYour NameYour NameOnly required if participant is taking medications at present. This participant is taking medication at present. The parent/guardian will ensure medications are well-labeled and will bring such medications and present them to the parish/school. If applicable, the medication may be administered by someone other than the school nurse, who will be a qualified designee. Please sign to provide your consent.Please list all allergic reactions:Medications, foods, plants, insects, etc.Date of last tetanus/diptheria immunization(Required)Does this participant have a medically prescribed diet?Any physical limitations?Is this participant subject to emotional reactions or anxiety in new situations?Has this participant recently been exposed to contagious disease or conditions, such as mumps, measles, chicken pox, etc? If so, list date and disease condition.You should be aware of these special medical conditions of this participant:Signature - Release for Photo/Media Recording(Required)Your NameYour NameYour NameYour NameI, the undersigned, do hereby grant permission to the Office for Vocations and the Diocese of Fall River to use the image, video and/or audio of my child. I understand that the decision to use any still images, video and/or audio recording for informational and/or promotional purposes will be made by the aforementioned Office for Vocations/Diocese of Fall River. I also understand that any such still image, video and audio obtained may be widely shown throughout the Diocese and beyond, including print materials, websites, social media, the internet, and network or cable television, to reach any and all potential targeted audiences.
