Thank you for registering for Quo Vadis Days! Before your child can be enrolled, the below form must be completed and signed by the child and a parent/legal guardian.

Youth Confidential Release and Medical Form

    I, the undersigned parent/guardian, give permission for my son/daughter who is named below to participate in Quo Vadis Day July 18-21, 2021.

  • It is understood that reasonable caution will be taken by the organizers to prevent injuries to all participants. In the event of injury or illness to our/my child during his/her participation in this event, and if the parents/guardians of the mentioned persons cannot be reached, We/I hereby give our/my permission to the Quo Vadis Team for the necessary medical treatment to be given to our/my child.
  • We/I for ourselves/myself and for our/my child, our/my respective heirs, and our/my respective legal representatives, so hereby indemnify and hold harmless any representative of the Diocese of Greensburg, Christ Our Shepherd Center, or the Quo Vadis Team from any and all claims, demands and causes of action of whatever kind and nature for their actions taken pursuant to this authority.
  • I/We agree that in case of injury to our/my child, we will apply our/my hospitalization and/or accident insurance toward the payment of the expenses incurred.
  • I/We, hereby release and hold harmless the Diocese of Greensburg, Christ Our Shepherd Center, or the Quo Vadis Team, their agents, successors, legal representatives and any and all of its employees from any and all liability for any and all damages or personal injuries arising to my/our son as a result of his participation in Quo Vadis Day, except for damages and/or personal injuries caused by or arising out of the intentional or willful misconduct of the Diocese of Greensburg, Christ Our Shepherd Center, or the Quo Vadis Team, its agents, servants or employees.​
    The undersigned also agrees to authorize the Diocese of Greensburg to photograph, videotape and/or interview the named youth and agree that they may use or permit other persons to use the negatives, prints, video or interview prepared for such purposes and in such manner as may be deemed appropriate and necessary.
  • Please indicate if you do not agree to have your child photographed, interviewed or videotaped by checking the box in the Media Release section below.
    I understand that if, for whatever reason, at any point in time, I decide to revoke this authorization, and I so notify the Vocation Office in writing, references to the named youth (including images or interview) will no longer be used. Any website references will be removed within thirty (30) days of written notification. I further understand, however, that references to the named youth may continue to be used in any publication already printed or published prior to my revocation of the authorization provided herein.

    Code of Behavior: Participation in Quo Vadis Day is a privilege and not a right. Each youth and adult must attend all scheduled activities. The behavior of all must reflect Christian values. Drugs/Alcohol are not permitted. The staff reserve the right to ask any participant to leave at the participant’s own expense. I/We have read and agree to uphold the above “Code of Behavior”.

Medical Information

Please indicate dosage, frequency, etc.

Emergency Contact

In case of emergency notify:

Media Release

Signature of parent or guardian

A parent or court-appointed legal guardian must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document as set forth above.