MARCH FOR LIFE WASHINGTON, DC

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1 MARCH FOR LIFE WASHINGTON, DC What is the March for Life? It is an annual Pro-Life Rally held in Washington, D.C. on the anniversary of the decision in the United States Supreme Court case Roe vs. Wade. This is a peaceful march that does not involve protesting or opposition of any kind. We will march with hundreds of thousands of other people for the rights of all people, especially the most vulnerable, babies in the womb. Departure: 4 p.m. Wednesday, January 21, 2015 (from St. Mary Church 340 N. Main Street Hudson, OH 44236) March for Life: Thursday, January 22, 2015 Return: Midnight 1 a.m. Thursday night /Friday Morning (Drop-off locations to be determined. Teens will call home when 1 hour away from drop off) Trip Itinerary Wednesday, Jan. 21 arrive at St. Mary Church (Lower Hall) at 3:45 p.m. for check-in, bus assignment, and departure at 4 p.m. The trip takes approximately 7-8 hours. (arrival Falls Church, VA. approximately midnight) Bring a packed snack for the afternoon bus ride. Bring money for dinner stop and extra food purchases along the way. Thursday, January 22 begins with continental breakfast on the way to a Rally at Patriot Center on the campus of George Mason University with Mass including lunch after mass, and a concert, trip to DC where the March for Life takes place. The buses will leave to return to Ohio immediately after the March. We should arrive back at St. Mary/St. Basil the Great* between 12:00 midnight and 1:00 a.m. Thursday Night/Friday morning. The teens will be instructed to call home close to arrival. *EXACT DROP OFF LOCATIONS TO BE DETERMINED Trip Information Overnight accommodations: (4 teens to a room) LIFE TEEN will provide a continental breakfast and a Chick-fil-A lunch at the rally on Thursday. You may pack a meal, or bring money for dinners and all purchases on the road. You will need warm clothes and good walking shoes. Plan to layer according to weather. COST: $130 per person includes round trip charter bus transportation and overnight accommodations, entrance to rally/concert and 2 meals. Checks payable to St. Mary Church. Donations to help us meet our costs would be greatly appreciated! Thank you! ST. MARY PARISH OF HUDSON - LIFE TEEN office ext: 253 or 257 EMERGENCY CELL NUMBERS: (Ron Nowak) (Tommy Dome) (Paul Koopman) (Barbie Byrne)

2 LIFE IS VERY GOOD - EVENING OF PRAYER AND MORNING RALLY WEDNESDAY JANUARY 21 AND THURSDAY JANUARY 22, 2015 We invite you to join groups from all over the country at one or both of these events! The Morning Rally will prepare us to take to the streets of Washington D.C. to make our voices heard as we proclaim the gospel of life. The events will be held at the Patriot Center on the campus of George Mason University. EV E N I N G O F P R A Y E R J A N 2 1 7:30pm-10:00pm, doors open at 6:30pm Featuring: Matt Maher, Chris Stefanick, and Rend Collective Tickets: $15 each. Reserved seating in order of payment. M ORNING RAL L Y A N D M A SS JAN 22 9:00am-12:00pm, doors open at 8:00am Featuring: Chris Stefanick and Ike Ndolo Band Tickets: $16.50 each. Includes a Chick-fil-A lunch to go. Reserved seating in order of payment.

3 MARCH FOR LIFE WASHINGTON, DC 2015 MARCH 4 LIFE REGISTRATION Payment $ Check # Date rec d Name of Participant Adult / Student Grad.Yr_ Home Address Cell Phone Home Parish:_ Parent/Guardian Address street city state/zip Home phone PARENTS: WE MUST HAVE A NUMBER WHERE YOU CAN BE REACHED AT ANY TIME Home PhoneWork Phone_Cell Phone Emergency Contact _Phone I HAVE ENCLOSED $ PER PERSON ATTENDING (made out to St. Mary Church) ADULT TEEN MY TEEN HAS SIGNED THE STATEMENT OF RESPONSIBILITY (BELOW). I HAVE COMPLETED THE MEDICAL RELEASE (INCLUDED WITH THIS FORM). TEEN STATEMENT OF RESPONSIBILITY: I REQUEST TO PARTICIPATE IN THE MARCH FOR LIFE IN WASHINGTON, D.C. I UNDERSTAND THAT BY REQUESTING TO GO, I AM PROMISING TO ABIDE BY ALL RULES, OBEY ALL CHAPERONES, AND OBSERVE CHECK-IN TIMES. I ALSO REALIZE THAT I MAY NOT BRING OR USE ILLEGAL DRUGS OR ALCOHOL AND THAT I CANNOT SMOKE. TEEN SIGNATURE ROOMMATE REQUEST (4 per room): PHOTO RELEASE I/We, the parent(s) of, give my/our permission to St. Mary Catholic Church in Hudson & Holy Family Parish in Stow, Ohio to publish my/our child s photo only (no name) in following publications/media forms exclusively for the purpose of St. Mary Catholic Church and its parishioners: DVD for things such as Welcoming, Parish History, etc.; Parish Bulletin and/or Parish Bulletin Cover; Parish Website, Parish Information Booklet; Hudson Hub; Catholic Universe Bulletin; and Parish Brochures to advertise programming. This permission is for one/ one time permission related to R2L Trip to Washington DC. Mother Date Father Date

4 PERMISSION / RELEASE FORM I/we as the parent(s) or legal guardians of (participant s name-please print) do hereby grant permission for the aforesaid to participate in the March for Life in Washington DC. I/we hereby grant permission for the aforesaid to travel to and from these activities via charter bus. OR I, AM 18 YEARS OF AGE AND I/we agree by my/our signature(s) to release, absolve, indemnify and hold harmless St. Basil The Great, St. Mary of Hudson, St. Francis Xavier Church, Holy Family or Sacred Heart Church, the Roman Catholic Diocese of Cleveland, the Bishop of the Roman Catholic Diocese of Cleveland and any and all Catholic Churches or Parishes and any and all supervisors, volunteers, organizers or sponsors thereof, and from any and all liability for injury, medical fees, hospital bills, or doctor bills of aforesaid participant. I/we waive all claims of any kind against any or all of the organizations or persons hereinabove enumerated, including any and all claims against person or persons transporting aforesaid to or from any activities hereinabove named. I/we also give my/our permission to videotape/photograph my/our child without limitation, to use such pictures and or stories in connection with any of the work of the parish community and the Catholic Diocese of Cleveland without consideration of any kind. PARENT SIGNATURE(S) _ DATE PARTICIPANT S SIGNATURE DATE (over 18 years of age) AUTHORIZATION FOR MEDICAL TREATMENT I, as parent or legal guardian of do hereby give my consent for St. Basil the Great, St. Mary of Hudson, St. Francis Xavier, Holy Family and Sacred Heart Staff and the chaperones, or other adult representative, in the event that all reasonable attempts to contact me have been unsuccessful, to seek medical attention and treatment deemed necessary by medical personnel. I give my permission to transfer my child to the nearest hospital. Our healthcare insurance carrier is _Phone This authorization does not cover major surgery, unless the medical opinion of two other licensed physicians concur on the necessity for such surgery and are obtained before surgery is performed. Please list allergies and medical conditions List any medication (including dosage) that they are taking Are there any medical conditions of which we should be aware Parent/Guardian Signature Date Participant s Signature_ Date (if over 18 yrs of age)

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