17-18 RE Registration
Date of Birth
If yes, please explain.
Home Phone Number
Cell Phone Number
Parent/Gaurdian Signature & Date - Medical
I give permission for my son and/or daughter to participate fully in the Religious Education Program at Holy Family Catholic Church, including snacks and games. In case of an emergency, I understand that every effort will be made to contact the parents/guardians of the child(ren). In the event that I cannot be reached, I hereby give permission for the medical personnel selected by the Director of Religious Education and Teachers to secure proper and necessary treatment for my child(ren) as named on this form.
PLEASE TYPE NAME BELOW IF IN AGGREEMENT
Physician Name, Clinic & Phone Number
Parent/Gardian Signature & Date - Media
I understand that during the course of the year pictures may be taken to help us remember the events of the year. I give permission for my child’s or children’s picture to be used in church publications such as but not limited to; the newsletter and web-site.
PLEASE TYPE NAME BELOW IF IN AGREEMENT
Send me a copy of my responses
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