Form 2of 3

Diocese of Palm Beach
Parent's Authorization for Travel

I hereby give my consent for my daughter/son:_________________________________
to participate in ____________________________________________________________
including travelling from: ___________________________________________________
______________________________________________________________________________
The group will be travelling by _____________________________________________.
I understand that although the diocese/parish is sending a representative with 
the youth, it would be impossible for the representative to supervise every 
individual activity and action of the youth.

I understand that neither the Diocese of Palm Beach, the parish, the parish 
youth minister, the parish chaperone nor the staff is liable in the event of 
an accident or injury to my child.  I also assume full responsibility for the 
consequences of my child's actions during these activities.

Make checks payable to: DIOCESE OF PALM BEACH
(Click here to get form 3)