RC Activities, Inc.
1. NATURE AND DURATION OF ACTIVITIES: Mercy Mission Atlanta mission to be held
in Downtown Atlanta. Exact address is provided in Mission Readme email sent 24 hours
prior to mission start. Timing available via mercymissionsatlanta.com and the
registration confirmation email.
2. ACTIVITY SUPERVISOR(S):  Mission Leadership is listed as following:
1. Tanner Mitas - tanner.mitas@mercymissionsatlanta.com
2. Emmy Henkel - emmy.henkel@mercymissionsatlanta.com
3. Fr. John Klein - john.klein@mercymissionsatlanta.com
3. TRANSPORTATION: Transportation is not available for this mission unless stated
otherwise. 
4. MENTORING:  Participants may be offered mentoring, which is intended to help young
people personalize the principles of Christian living that they receive at home and in
club activities.  Mentoring involves a one-on-one conversation with an adult conducted
in plain view of others.  When dealing with adolescents, confidentiality will be
maintained to foster openness of dialogue, but situations involving sexual abuse of a
minor or threats to life or physical health will be reported to the appropriate authority and
to the parents (except in those cases where the parent may be the alleged abuser).
5. REQUIREMENTS: The child named above is in good health and has no physical or
medical limitations that would cause the activities as described above to be detrimental
or dangerous to the child.  Parents/guardians should specify allergies and medical
problems on registration form.
6. CONSENT:  I/We hereby consent to the above-named child's participation in the
activities described above including mentoring, and specifically request that he be
allowed to participate in those activities.  I/We warrant that I/We have full authority to
legally consent to her participation in the activities described on this form, and all
provisions contained herein.
7. AUTHORIZATION: I/We hereby authorize RC Activities, Inc. to use the image and
likeness of my/our child in photograph or video form whether taken by or commissioned
by RC Activities, Inc. in its promotional materials and for its promotional purposes
associated with its nonprofit activities. This authorization shall extend to use of my/our
child’s image and likeness on the website of RC Activities, Inc., or its successor in
operation or affiliated organization(s) upon written consent of RC Activities, Inc.  I/We
understand that this authorization shall survive the end of my/our child’s participation in
the activities referenced on this form.
8. INSURANCE:  I/We understand that RC Activities, Inc. does not carry any health
insurance relative to the activities or for any injury that may occur to the above-named
child.  I/We represent that the child is (a) covered by insurance through my/our own
insurance carrier; or (b) that I/We am/are personally financially responsible for any and
all medical costs incurred as a result of the child's injury.
9. EMERGENCIES:  If the above-named child requires any emergency medical
procedures or treatments during the activities, I/We consent to the activity supervisor(s)
taking, arranging for or consenting to such procedures or treatments in the discretion of
the activity supervisor(s).  For purposes of such procedures and treatments, my/our

child's blood type allergies or other medical problems (if any) are listed below:                
10. EMERGENCY CONTACTS:  If, in the event of a medical or other emergency, I/We
am/are unable to be reached by telephone at the numbers listed on the form, I/We
authorize the activity supervisor(s) to attempt to contact me/us through the alternative
emergency contacts listed below.
11. I/We give permission for Event Supervisor(s) and Leader(s) to communicate with my
child using text messaging and/or email regarding the details of the Activity / Program
(Only participants 15 years old and older).
12. RELEASE AND INDEMNIFICATION:  I/We release and waive, and further agree to
indemnify, hold harmless or reimburse RC Activities, Inc. and Consolidated Catholic
Administrative Services, Inc., the individual members, agents, directors, officers,
employees, volunteers and representatives thereof, as well as activity supervisors, from
and against, any claim which I, any other parent or guardian, any sibling, the above-
named child, or any other person, firm or corporation may have or claim to have, known
or unknown, directly or indirectly, for any losses (including attorneys’ fees incurred by
RC Activities, Inc. and Consolidated Catholic Administrative Services, Inc., or any of its
individual employees, agents, volunteers, etc. in enforcing this indemnity provision)
without limitation in time or amount, damages or injuries arising out of, during, or in
connection with my/our child's participation in the activities, the travel to and there from,
and the rendering of emergency medical procedures or treatment, if any. I/We
understand that this release and indemnification shall survive the end of my/our child’s
participation in the activities referenced on this form and shall have no limitation in time
or amount.