Waiver form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=110 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="05cf0f21egerdp.jpg"> <div> <B><IMG SRC="04f203c0.jpg" border=0 width="32" height="60" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><FONT SIZE="5" COLOR="#66334C" FACE="Arial" ><B>T.O.R.C.H. of Chester County, PA                                                     Holy Family Chapter</B></FONT><B>      |     </B><A HREF="index.htm" TARGET="_top" TITLE="T.O.R.C.H. of Chester County, PA "><U><B>home</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Calendar"><U>Calendar</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="Mission"><U>Mission</U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="A Sampling from our last Newsletter"><U>A Sampling from our last Newsletter</U></A>   |   <A HREF="id25.htm" TARGET="_top" TITLE="Related Links"><U>Related Links</U></A>   |   <A HREF="id26.htm" TARGET="_top" TITLE="Archdiocesan Guidelines for Preparing Ch"><U>Archdiocesan Guidelines for Preparing Children Being Educated at Home for the Reception of First Penance, First Holy Communion and Confirmation                                                    December 4, 1998</U></A>   |   <A HREF="id27.htm" TARGET="_top" TITLE="Where in PA are we?"><U>Where in PA are we?</U></A>   |   <A HREF="id28.htm" TARGET="_top" TITLE="Dues"><U>Dues</U></A>   |   <B>Waiver form</B>   |   <A HREF="id30.htm" TARGET="_top" TITLE="What is Armata Bianca?"><U>What is Armata Bianca?</U></A>   |   <A HREF="id31.htm" TARGET="_top" TITLE="Parish Schedules"><U>Parish Schedules</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="05bf2f02egerdp.jpg"> <div> Please print this form, fill out and mail with your dues.   </div> </td> <td valign="top" height=370 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="05ef0f03.jpg"> <div> <I>Waiver form</I></div> <bR> <bR> <div> <I>TORCH Release and Waiver</I></div> <div> <I>I hereby release Traditions of Roman Catholic Homes and it's chapters, officers, members, employees, and volunteers (referred to collectively here as "TORCH"), from any and all liability for damage or injury to my children or myself or to any person or property during the time of my children's attendance at TORCH activities whether or not such damages were sustained in connection with any TORCH activities.  I hereby agree to indemnify and hold harmless TORCH from any claims, including the cost of expenses, arising in connection with injuries or damage sustained by my children or me.</I></div> <div> <I>I assume full responsibility for my children's behavior, for assuring their supervision during TORCH activities, and for any damage or injury caused by my children's actions.</I></div> <bR> <div> <I>Children's Names                                                             Children's ages</I></div> <div> <I>_____________________________________</I></div> <div> <I>____________________________________</I></div> <div> <I>____________________________________</I></div> <div> <I>____________________________________</I></div> <div> <I>____________________________________</I></div> <div> <I>____________________________________</I></div> <div> <I>____________________________________</I></div> <div> <I>____________________________________</I></div> <div> <I>____________________________________</I></div> <div> <I>Date:______________</I></div> <div> <I>Signature of Parent or Guardian__________________</I></div> <div> <I>Telephone #:  (H)_______________(W)____________</I></div> <div> <I>E-mail address:_______________________________</I></div> <div> <I>Mailing Address:______________________________</I></div> <div> <I>___________________________________________</I></div> <div> <I>___________________________________________</I></div> <div> <I>___________________________________________</I></div> <div> <I>Parish:______________________________________</I></div> <bR> </td> </tr></table></body>