If you will be 18 years old by July 11, 2021, please fill out the Adult Registration Form.  If not, complete this form.

I understand the above expectations and consequences as they have been set forth by the staff of Resurrection Parish. I will obey these rules and any others made before and/or during the trip.

I understand the above expectations and consequences for my child as have been set forth by the staff of Resurrection Parish. I understand that if my child does not comply, they will incur the aforementioned consequences. I agree to all of the above, and if my child should be dismissed from the trip, I will make arrangements to pick them up within 12 hours.

The Appalachia Mission Trip has my permission to use my/my child's photograph publicly to promote the Appalachia Mission Trip. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

In the event of any injury or illness to my/our child during his/her participation in this event, I/we hereby give my/our permission for the necessary medical treatment to my/our child. I/We agree that in case of injury to my/our child, I/we will not look to Resurrection Parish or the Roman Catholic Diocese of Pittsburgh for the payment of any medical costs or injury-related costs.

Liability Release: In consideration for being accepted by Resurrection Parish for participation in this event, we(I), being 21 years of age or older, do for ourselves (myself) (and for and on behalf of my child-participant if said child is not 21 years of age or older) do hereby release, forever discharge and agree to hold harmless Resurrection Catholic Church and the Diocese of Pittsburgh, thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant while said child is participating in the above described event. Furthermore, we (I) (and on behalf of our (my) child –participant if under the age of 21 years) hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. Further, authorization and permission is hereby given to Resurrection Parish to furnish any necessary transportation, food and lodging for this participant. The undersigned further hereby agree to hold harmless and indemnify Resurrection Parish, and its employees and agents, for any liability sustained as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant there to. (If the participant has not attained the age of 21 years): We(I) are the parent(s) or legal guardian(s) of this participant, and hereby grant our (my) permission for him/her to participate fully in said event and hereby give our(my) permission to take said participant to a doctor or hospital and hereby authorize medical treatment, including but not in limitation to emergency surgery or medical treatment, and will assume the responsibility of all medical bills, if any. Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action or otherwise, we(I) hereby assume all transportation costs.