Please Carefully Read Through the Following Acknowledgements, Policies, and Conditions of Participation for the Imago Dei Retreat. When finished, please type your name below as a signature. If you are a teen filling out this form, ask your parent or guardian to complete this remaining section.
General Assumption of Risk and Liability Release. In consideration for my teen’s participation in the Imago Dei Retreat and intending to be legally bound, myself and my teen agree and understand that we assume all risk of our participation in this retreat and with full knowledge of the risks inherent in such a program, we do hereby release and forever discharge Saint Peter Catholic Church, the Archdiocese of Philadelphia and their employees, volunteers, chaperones, agents, administrators, and any official representatives from any/all liability, damages, actions or suits in law or equity which we might hereafter have by reasons of personal or bodily injury, and/or property damage arising from or related by our teen participating in this retreat. In case of emergency, we give permission for our teen to receive necessary medical treatment until the emergency contact can be notified and we agree to be responsible for payment of said medical treatment. If the need arises, I give permission for my teen to be given basic over-the-counter medication, such as Advil or Tylenol, supervised by adult staff or volunteers of the retreat. If my teen requires prescription medication, I consent to him or her being in posession of said prescription medication for the length of the retreat and managing his or her own dosage and administration of the prescription medication.
Photography and Media Release. I give consent for my teen’s photo or video to be taken as a part of the retreat. I give consent for my teen’s photo, video, name, and likeness to be used or posted on any parish, school, or organizational website or social media account within Saint Peter Catholic Church and the Archdiocese of Philadelphia. I hereby consent to the use of any videos, photographs, slides, audio or any other audio or visual reproduction in which the teen registering on this form may appear by Saint Peter Catholic Church and the Archdiocese of Philadelphia. I understand that these materials may be used for promotional purposes including recruitment and fundraising efforts or general publication. Promotion may include but is not limited to slide presentations, photo displays, social media promotions, and electronic multi-media display. I agree that the photograph image shall be free for use and release Saint Peter Catholic Church and the Archdiocese of Philadelphia, its employees, volunteers, and agents for any liability connected with the use of said photograph or image.
Electronic Communication with Minors Consent. I give permission for my teen to receive updates and information about the retreat via email from the volunteers within Saint Peter Catholic Church.
Standards of Behavior. On this retreat, Saint Peter Catholic Church strives to create a joyful, welcoming environment where all teens can come to encounter Christ. We strive to use our speech to uplift, affirm, and show gratitude to others. We commit to receiving and welcoming one another as if we were welcoming Christ Himself. As such, each teen commits to upholding the standards of this environment and following all the directives of the staff and volunteers of the retreat. There is a zero-tolerance policy for any bullying, threats, harassment, or any other kind of behavior deemed inappropriate. Repeated disregard for these standards will lead to potential consequences up to and including dismissal from the retreat without refund.
Prohibited Items and Consent to Search
As the parent/legal guardian of the participant named above, I understand and acknowledge that Saint Peter Catholic Church prioritizes the safety and well-being of all attending the retreat. As such, prohibited items on this retreat include but are not limited to, alcohol, drugs, cigarettes, cigars, vapes, nicotine pouches, weapons, or any other illegal or age restricted product.
All teens will be given the opportunity to turn in any of the above mentioned items within the first hour of the retreat without consequence. After that point, if the need arises, I grant Saint Peter volunteers or designated representatives the right to search the belongings of my teen, including but not limited to bags, suitcases, and room accommodations, if there is a reasonable suspicion that the participant may possess any prohibited or illegal items.
I understand that this search will be conducted with the utmost respect for my child's privacy and belongings. In the event that prohibited or illegal items are found, they will be confiscated, and appropriate action will be taken, which may include immediate dismissal from the retreat without a refund and, if necessary, involvement of law enforcement.
Acknowledgement of Overnight Retreat Standards
I understand and consent to my teen sharing a double occupancy retreat room with another teen on the retreat. Adult chaperones will be staying in the same retreat building with teens with separate and designated restrooms and sleeping quarters. Each teen participant will follow all directives of the retreat chaperones and volunteers in regards to curfew and quiet hours at night.