ROLLER COASTERS. JESUS. JOY.

SCHEDULE (Tentative): Departing Friday ~5pm,

November 2nd, Dinner. Depart for Santa

Clarita. Overnight stay at local Church

Returning Sunday AM, November 4th,

Breakfast. Spend the day at Six Flags Magic Mountain. Catholic

Teen Rally. Mass. Adoration. Awesomeness. Return Home.

COST: $135 Includes: Transportation &

Lodging Arrangements. Friday Dinner. Saturday

Breakfast. Park and Event Admission. Bring extra cash for Sat Lunch & Dinner, park

merch, snacks, etc.

SIX FLAGS MAGIC MOUNTAIN TRIP

November 2-4, 2018 Valencia, CA

RSVP BY: Sunday, Oct. 21st, 2018 With $50 deposit or full

payment Plus Permission slip

Please make all checks to: St. Thomas Aquinas Parish. 3290 Middlefield Rd. Palo Alto, CA 94306 Questions? Contact Chris Mardesich at (650) 494-2496 ex21. or cmardesich@dsj.org

2018  Inspiration  Los  Angeles   Saturday,  November  5,  2016  

Time   Schedule   Location   10:00am-­‐12:00pm   Registration   Front  of  Park  

10:30am-­‐6:00pm   Groups  enjoy  Six  Flags  Park   Six  Flags  Magic  Mountain  

1:00-­‐2:00pm   Military  Meet  &  Greet   Golden  Bear  Theater  

5:30pm   Doors  Open   Golden  Bear  Theater  

5:30-­‐6:00pm   Music   Golden  Bear  Theater  

6:00-­‐6:05pm   Host  Welcome   Golden  Bear  Theater  

6:05-­‐7:10pm   Mass   Golden  Bear  Theater  

7:10-­‐7:15pm   Transition  Song   Golden  Bear  Theater  

7:15-­‐7:30pm   Host  Interaction  &  Icebreaker   Golden  Bear  Theater  

7:30-­‐8:00pm   Keynote Golden  Bear  Theater  

8:00-­‐8:10pm   Praise  &  Worship   Golden  Bear  Theater  

8:10-­‐8:45pm   Adoration   Golden  Bear  Theater  

8:45-­‐8:55pm   Benediction  &  Closing  Song   Golden  Bear  Theater  

8:55-­‐9:00pm   Closing  Remarks   Golden  Bear  Theater  

9:00pm   Exit  Park  (Park  Closed  at  8pm)  

Revised 05/02/2012

DDiioocceessee ooff SSaann JJoossee _____________________________ R I S K & I N S U R A N C E M A N A G E M E N T

Student Activity Waiver Form General Liability

Parish Information: St. Thomas Aquinas—Catholic Community of Palo Alto

Location Name: Six Flags Magic Mountain Location #:

Location Address: 26101 Magic Mountain Parkway

Valencia, CA 91355

Telephone: (925) 819-2406

Contact Name: Chris Mardesich Facsimile:

NOTICE TO ADMINISTRATORS/SUPERVISORS: THIS FORM MUST BE COMPLETED AND COPY FILED WHEN A STUDENT PARTICIPATES IN AN ACTIVITY SPONSORED BY THE SCHOOL OR PARISH.

REFER ANY QUESTIONS TO RISK & INSURANCE MANAGEMENT TELEPHONE: 408-983-0250 / FACSIMILE: 408-983-0296.

Student Personal Information

Student Name: Telephone:

Home Address:

Parent Name: Telephone:

Medical Plan Name: Policy Number:

Medical Plan Address: Telephone:

Emergency Contact Name: Telephone:

Emergency Contact Name: Telephone:

Activity Information

Date of Activity: 11/2-11/4, 2018 Name of Activity: Life Teen Inspiration LA 2018

Description of Activity: A day of roller coasters, fun, and a huge Catholic teen rally with an engaging speaker and encounter with Christ in

the Mass, $135 cost includes transportation (Passenger van rentals pending number of total participants), Friday Dinner, Saturday breakfast, Theme Park Admission, Life Teen event Admission. Bring extra cash for Lunch, Dinner, and misc items.

Waiver Authorization

FORM MUST BE COMPLETED IN ALL RESPECTS, SIGNED AND DATED TO AUTHORIZE THE WAIVER.

I HOLD THE PARISH AND DIOCESE OF SAN JOSE HARMLESS FROM ANY CLAIM OF INJURY, SICKNESS, ILLNESS OR DAMAGE THAT MY CHILD MAY SUFFER OR SUSTAIN DURING THE ACTIVITY LISTED ABOVE, WITH EXCEPTION TO INJURY OF DAMAGES ARISING OUT OF THE SOLE NEGLIGENCE OF THE PARISH OR DIOCESE OF SAN JOSE.

I ATTEST THAT MY CHILD IS PHYSICALLY FIT TO PARTICIPATE IN THIS EVENT.

IN THE EVENT MY CHILD BECOMES ILL OR INJURED, I DO HEREBY CONSENT TO WHATEVER X-RAY, EXAMINATION, MEDICAL OR TREATMENT AND HOSPITAL CARE ARE CONSIDERED NECESSARY IN THE BEST JUDGEMENT OF THE ATTENDING PHYSICAIN AND PERFORMED BY OR UNDER THE SUPERVISOIN OF A MEMBER OF THE MEDICAL STAFF OF THE HOSPITAL FACILITY PROVIDING THE TREATMENT.

I AM NOT AWARE OF ANY MEDICAL CONDITION WHICH WOULD RENDER IT INAPPROPRIATE FOR MY CHILD TO PARTICIPATE IN ANY SUCH ACTIVITY.

Parent Signature: Date Signed:

Office Use Waiver Received By: Date Received:

Life  Teen  Events                             6105  Blue  Stone  Rd.  Ste.  B     Atlanta,  GA    30328        

                                                   P:  404-­‐252-­‐8815                        F:  404-­‐252-­‐8818                                              events@lifeteen.com      

 

 

EVENT:  _____________________________________      

PARTICIPANT  AGREEMENT  FORM   (for  youth  &  adults)  

 

  PARTICIPANT’S   INFORMATION:  (please  print)                              LAST  NAME:  ______________________________________________                            FIRST  NAME:  ______________________________________________                                        ADDRESS:  ______________________________________________                                                                                                CITY:  _____________________________________________                                                      STATE:  _______________________      ZIP  CODE:  ___________                                                                              PHONE  #:  _____________________________________________  

         EMAIL:  _____________________________________________  

                             BIRTH  DATE:  _____________________________________________  

  GENDER:          MALE          FEMALE  

     PARISH:  _____________________________________________  

                                             DIOCESE:  _____________________________________________  

      HEALTH   INFORMATION:                                                                  DOCTOR:  __________________________________________                    DOCTOR  PHONE  #:  __________________________________________                                INSURANCE  CO.:  __________________________________________                              INSURANCE  ID  #:  __________________________________________      INSURANCE  GROUP  #:  __________________________________________     CARDHOLDER’S  NAME:  __________________________________________     PARTICIPANT’S  ALLERGIES  (including  meds  and  food):  ________________     ________________________________________________________________     PARTICIPANT’S  CHRONIC  MEDICAL  PROBLEMS  (e.g.  diabetes):  _______     ________________________________________________________________     PARTICIPANT’S  OTHER  PHYSICAL  RESTRICTIONS:  __________________     ________________________________________________________________    

        EMERGENCY  CONTACT:                                                      NAME:  _______________________________________________                                      PHONE  #:  _______________________________________________          RELATIONSHIP  TO  PARTICIPANT:    _______________________________        

  WAIVER:     I,  _____________________________________________,