Day of Formation for Women

REGISTRANT INFORMATION

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
Street Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
eMail Address REQUIRED Please fill out this field. Please enter an email address.

REGNUM CHRISTI

Are you a Regnum Christi member? REQUIRED Yes No Please fill out this field.
If yes, please enter the name of your team leader Please enter valid data.

MEDICAL

Medical need requiring special room accommodations (including nursing mothers)? Sorry, we are unable to accommodate food allergies and dietary restrictions. REQUIRED Yes No Please fill out this field.
If YES, Please Specify Your Requirement Please enter valid data.

EMERGENCY CONTACT

Emergency Contact - Full Name and Relationship REQUIRED Please fill out this field. Please enter valid data.
Emergency Contact - Phone Number REQUIRED Please fill out this field. Please enter a phone number.

LUNCH SELECTION

Please select the boxed lunch of your choice: REQUIRED Cobb salad boxed lunch Ham sandwich boxed lunch Turkey sandwich boxed lunch No lunch (if registering for the virtual option) Please fill out this field.

COVID-19 TERMS AND CONDITIONS

RELEASE AND INDEMNIFICATION
I 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 parent or guardian, any sibling, 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 participation in the activities, the travel to and there from, and the rendering of emergency medical procedures or treatment, if any.  I understand that this release and indemnification shall survive the end of my participation in the activities referenced on this form and shall have no limitation in time or amount.

ASSUMPTION OF COVID-19 RISK AND WAIVER OF LIABILITY
By completing my registration, I acknowledge [for myself and/or my child(ren)] the highly contagious nature of COVID-19, as well as its potential to cause infection, illness, injury, permanent disability, and death.  I voluntarily accept and assume the risk that I may be exposed to or infected by COVID-19 by visiting / participating/attending the above named event operated by RC Activities, Inc. I further accept [for myself and/or my child(ren)] and assume the risk that such exposure or infection may result in my [my child(ren)] personal injury, illness, permanent disability, and/or death.  RC Activities, Inc. cannot prevent you [for yourself and/or your chlld(ren)] from becoming exposed to, contracting, or spreading COVID-19 while visiting/participating/attending the above named event.  It is not possible to prevent against the presence of the disease.  Therefore, if you [for yourself and/or child(ren)] choose to visit / participate/attend the above named event you  [for yourself and/or your child(ren)] may be exposing yourself [your child(ren)] to and/or increasing your risk of contracting or spreading COVID-19.

I understand that the risk of becoming exposed to or infected by COVID-19 may be increased as a result of the actions, omissions, and/or negligence of RC Activities, Inc., including its independent contractors, agents, vendors, guests, and employees.  I voluntarily assume  [for myself and/or my child(ren)]  all of the risks of COVID-19 and of COVID-19 exposure and accept sole responsibility for any harm to me [my child(ren)] (including, but not limited to, personal injury, illness, permanent disability, and death).

In consideration of RC Activities, Inc. allowing me onto its premises / visiting / participating / attending the above named event I also, on behalf of myself [my child(ren)] and my successors and representatives, waive, release, and forever discharge RC Activities, Inc., and its agents, employees, officers, directors, contractors, customers, successors, and assigns from any and all claims and causes of action of any kind or nature which are in any way related, directly or indirectly, to COVID-19, which I may have or that hereafter may accrue, including any such claims or causes of action caused in whole or inpart by the negligence of RC Activities, Inc., its agents, employees, officers, directors, contractors, customers, successors, and assigns.  I [for myself and/or my child(ren)] further agree that I will not bring any claim or cause of action against RC Activities, Inc., its agents, employees, officers, directors, contractors, customers, sucessors, and assigns related in any way, directly or indirectly, to COVID-19 and/or any associated personal injuries, illness, disability, or death.

I [for myself and/or my child(ren)] further agree to indemnify, defend, and hold harmless RC Activities, Inc., its agents, employees, officers, directors, contractors, customers, sucessors, and assigns from any claims or causes of action of any kind arising from my exposure to COVID-19 as a result of visiting/participating/attending the above named event provided by RC Activities, Inc.

I HAVE READ AND UNDERSTAND THE ABOVE RELEASE AND INDEMNIFICATION AND ASSUMPTION OF COVID-19 RISK AND WAIVER OF LIABILITY AND AGREE TO ALL TERMS AND CONDITIONS CONTAINED THEREIN. REQUIRED Yes - I agree Please fill out this field.

EVENT FEES REQUIRED

50.0 – On-site Conference Fee

50.0 – Optional Friday Overnight at Our Lady of the Holy Spirit Center (does not include foodservice)

35.0 – Optional Pre-recorded Virtual Conference (link to recordings sent Friday evening, April 11) Please fill out this field.

Congratulations on Your Decision to Attend the Essential Elements of an Apostle

For RC Members of the Greater Cincinnati Women's Section

COVID Questionnaire

Janet Lees, Conference Speaker

Conference Details

"eSSENTIAL ELEMENTS OF AN APOSTLE"