2025 High School Ski Trip - Medical Consent & Permission Form

Trip Information

Event: High School Ski Trip
Location: Canaan Valley Ski Resort in Davis, WV
Date: Jan 30-Feb 2, 2025
Transportation: Carpool

Carpool leaves from Sacred Heart Thursday afternoon after school, and returns Sunday early afternoon. Students will need to be excused from school for at least Friday, Jan. 31 - if willing and able to, students who can also be excused on Thursday, Jan. 30 may be able to leave earlier.

Participants need to keep an eye on the weather reports for Davis, WV and pack accordingly! Girls and guys will be staying in separate houses. While the houses are large, there are typically at least some of us who will have to sleep on couches or bring sleeping bags. Once we have a better idea of our numbers we will update participants.

What will be covered by donors: lodging, group meals (if you want food outside of group meals, you will need to purchase yourself), and snow tubing.

Participants will need to pay for: lift tickets, any rental equipment (ski, snowboard, ice skating), and personal expenses. We learned previously that while you can reserve tickets and equipment in advance, it is not strictly necessary and is difficult to refund if plans change. You can look up the prices on their website: https://www.canaanresort.com/ski-winter-activities/skiing-snowboarding/lift-tickets/

When filling out this form, it is especially important to include any allergies or dietary needs/requests so that we can properly plan meals!

Deadline to sign up is January 17th.
Name Name First Last
Phone Phone - ### - ### ####
Email
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Emergency Contact Emergency Contact First Last
Emergency Contact Phone Emergency Contact Phone - ### - ### ####
Allergies
Medications (including frequency, dosage, etc.) Certain medications may need to be given to a chaperone prior to departure.
Special Considerations (asthma, dietary, accessibility, etc.)
Planning to ski/snowboard? If we know we have enough people ahead of time, we may be able to get a group rate.

Planning to ski/snowboard? If we know we have enough people ahead of time, we may be able to get a group rate. Yes Yes, and I have my own equipment Undecided No
Able to leave around 1:30pm Thursday? We might be able to send some of our group up early; if you are able to be excused from school and would like to join the early car, let us know.

Able to leave around 1:30pm Thursday? We might be able to send some of our group up early; if you are able to be excused from school and would like to join the early car, let us know. Yes No Maybe
Physician's Name Physician's Name First Last
Physician's Phone Physician's Phone - ### - ### ####
Health Insurance Company
Policy Number
Youth Code of Behavior

The following guidelines will ensure a fun and safe experience for all of us:
1) The possession of alcohol and illegal drugs is clearly prohibited and is cause for dismissal.
2) The Parish/Organization is responsible for the overall actions of the participants.
3) All participants, adults and youth, will be held to the highest Christian standards of morality.

I understand and agree to the Youth Code of Behavior. I also understand and agree that my parents or legal guardian will be notified at the time of any infractions requiring my dismissal from the event and that I will be sent home at my own and or parent’s/guardian’s expense.
Signature of Youth Attendee

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Parents:

In the event my child is injured or requires immediate and/or emergency care and I cannot be contacted, I authorize the event leaders to act for me according to his/her best judgment (including treatment and/or transportation to area medical facilities). I also authorize area hospital medical personnel to act on my behalf in the event of an emergency and I cannot be contacted.

I know that all possible care and safely will be provided for my child, therefore in case of an accident, to the fullest extend allowed by law, I agree to RELEASE FROM LIABILITY, AND TO INDEMNIFY AND HOLD HARMLESS, the Archdiocese of Washington, Sacred Heart Parish, La Plata; St. Catherine Parish, McConchie; St. Ignatius Parish, Hilltop; priests, deacons, teachers chaperones or representatives associated with the above event

I also agree to release from liability the Archdiocese of Washington, Sacred Heart Parish, La Plata; St. Catherine Parish, McConchie; St. Ignatius Parish, Hilltop; priests, deacons, teachers chaperones or representatives associated with the above event from any liability resulting from injury from, damage to - or damage caused by - my child at the event facility.

The Archdiocese of Washington, Sacred Heart Parish, La Plata; St. Catherine Parish, McConchie; St. Ignatius Parish, Hilltop; priests, deacons, teachers chaperones or representatives associated with the above event assume no liability for lost, stolen or damaged personal property.

I give hereby grant permission to the Archdiocese of Washington, Sacred Heart Parish, La Plata; St. Catherine Parish, McConchie; St. Ignatius Parish, Hilltop; to use any photographs and quotations taken of my child during this event to assist in community awareness, educational efforts, related public relations purposed that may include brochures, posters, website, official social media, and print media.
Signature of Parent/Guardian

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Adult Attendees:

In the event I am injured or require immediate and/or emergency care and my emergency contact cannot be reached, I authorize the event leaders to act for me according to his/her best judgment (including treatment and/or transportation to area medical facilities). I also authorize area hospital medical personnel to act on my behalf in the event of an emergency and my emergency contact cannot be reached.

I know that all possible care and safely will be provided for me, therefore in case of an accident, to the fullest extend allowed by law, I agree to RELEASE FROM LIABILITY, AND TO INDEMNIFY AND HOLD HARMLESS, the Archdiocese of Washington, Sacred Heart Parish, La Plata; St. Catherine Parish, McConchie; St. Ignatius Parish, Hilltop; priests, deacons, teachers chaperones or representatives associated with the above event.

I also agree to release from liability the Archdiocese of Washington, Sacred Heart Parish, La Plata; St. Catherine Parish, McConchie; St. Ignatius Parish, Hilltop; priests, deacons, teachers chaperones or representatives associated with the above event from any liability resulting from injury from, damage to - or damage caused by - myself at the event facility.

The Archdiocese of Washington, Sacred Heart Parish, La Plata; St. Catherine Parish, McConchie; St. Ignatius Parish, Hilltop; priests, deacons, teachers chaperones or representatives associated with the above event assume no liability for lost, stolen or damaged personal property.

I give hereby grant permission to the Archdiocese of Washington, Sacred Heart Parish, La Plata; St. Catherine Parish, McConchie; St. Ignatius Parish, Hilltop; to use any photographs and quotations taken of me during this event to assist in community awareness, educational efforts, related public relations purposed that may include brochures, posters, website, official social media, and print media.
Signature of Adult Attendee

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY

2025 High School Ski Trip - Medical Consent & Permission Form

2025 High School Ski Trip - Medical Consent & Permission Form

Trip Information

Youth Code of Behavior

Parents:

Adult Attendees: