LIABILITY ACKNOWLEDGEMENT FORM & CODE OF CONDUCT
CODE OF CONDUCT & Responsibility Policy
►PARENT'S INITIALS __________
PHOTO RELEASE & DIGITAL MEDIA AGREEMENT
I hereby authorize the making of photographs, motion pictures, videotapes, voice recording, usage
of online services ZOOM, Instagram Live, Groupme) of said session and my child’s participation
therein, and the publication and duplication or other use thereof. I hereby waive any rights to
compensation or any right that I otherwise might have to limit if to control such making or use.►►
►By checking this box,_______ I DO authorize any photos, videotapes, and voice recordings of my child as well as his/her usage of the online services mentioned above. ________PARENT'S INITIAL Date____________
►By checking this box, ______I DO NOT authorize any photos, videotapes, and voice recordings of my child as well as his/ her usage of the online services mentioned above. ______PARENT'S INITIAL Date__________
Protecing God's Children SAFE TOUCH PROGRAM
The Diocese of San Bernardino requires all parishes to present a sexual abuse prevention
program, the VIRTUS Touching Safety program to all children/youth/teens. We will present the Safe
Touch Program the months of November & February This program is provided to us by the Diocese of
San Bernardino and is a part of our ongoing effort to help create and maintain a safe environment
for children and to protect all children from sexual abuse. The Diocese expects 100% compliance.
►Parent’s Initial: ___________
NO REFUND POLICY
St Anthony’s policy states that all fees are non-refundable.
►Parent’s Initial: _____________
Please complete only if you have a teen in the youth Confirmation Program
For High School Confirmation Program ONLY – Sign-In/Out Permission
►I _____give permission _____do not give permission for son/daughter's name
to sign themselves in & out of Confirmation class when classes meet at the parish.
►Parent’s Initial: _________________
PARENT or GUARDIAN
►Please Print Name: _________________________________
►Signature (Parent/Guardian) _____________________________________________________ ►Today's Date _____________________________________________________________________
OFFICE COPY