Kenrick-Glennon Days

I hereby certify that the above information is correct and give permission for the release of medical records to an attending physician in case of illness. In case of medical emergency, I understand that every effort will be made to contact parent(s) or guardian(s) of participants. In the event that I cannot be reached, I hereby give permission to the physician selected by the Archdiocese to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child, as named herein.

I request that my son be allowed to participate in, and be transported to and from, Kenrick-Glennon Days at Kenrick-Glennon Seminary in St. Louis, MO. I hereby release and indemnify the Archdiocese of Kansas City in Kansas, its staff, and volunteers from any liability arising from claims of any kind or nature whatsoever from my son's participation in this program.

My son may be given over the counter medication (such as Tylenol, Tums, Advil, cough crops).

During the seminary visit, I give my permission to the Archdiocese of Kansas City in Kansas to take photographs and video of my child to possibly be used for future promotional items.

Kenrick-Glennon Days Registration Form

General Information

Health Information

Permissions and Liability