I consent to participation in this conference and trip. In consideration for my  participation, I agree to reimburse and indemnify the parish or Archdiocese of Milwaukee for all reasonable legal and court fees incurred by the parish or Archdiocese in defending a lawsuit that I may bring against the parish or Archdiocese of Milwaukee which relates to NCYC Milwaukee if the parish or Archdiocese is found not legally liable by the courts and prevails in the lawsuit. If the parish or Archdiocese is found legally liable for injuries sustained by me, this paragraph will not apply. 

I certify that I have an understanding of this agreement and any risks and hazards associated with participation in NCYC Milwaukee. I further understand that I had the opportunity to fully discuss this agreement with a representative of the parish or Archdiocese to clarify any concerns or questions about the activity or this agreement that I may have had. 

I have read the information above and I consent to participate in all aspects of this program. 

By entering my full name, I attest that this constitutes my legal electronic signature on this form.

Photo/Video Release

I hereby consent that any still or electronic image and/or video recording, in which I may appear, may be used by the Archdiocese of Milwaukee. I understand that these materials are being used for promotion of NCYC Milwaukee and/or the Archdiocese of Milwaukee. The images and/or recordings may be used to support participation, fundraising, evangelization and other communication efforts.

I release the staff and volunteers and I understand and agree that the use of my picture is not an invasion of privacy. Neither I, nor anyone claiming to be speaking on my behalf, will later object to the Archdiocese's use of these images and/or recordings.

By entering my full name, I attest that this constitutes my legal electronic signature on this form.

Emergency Medical Treatment & Contact 

In the event of an emergency, I give permission to be transported to a hospital for emergency medical treatment. I wish to have my spouse/emergency contact be advised prior to any further treatment by the hospital or doctor.

In the event of emergency, contact:

Medical Information and Consent: The following information will be used only in the event of an emergency in which you are unable to seek medical attention yourself.

Physician & Insurance Information

Other Medical Information & Medications