School:_____________________________________________ Grade as of September 2015? __________
New student? ___Yes ___No Transfer from another parish? ___Yes ___No If yes, name of parish: ____________________
Did this student attend Religious Education classes in 2014-2015? ___Yes ___No If so, what grade?_____
Is this student returning to Religious Education after a break of one or more years? ___Yes ___No
If yes, what was the last year and grade in which the student was enrolled? Grade_____ Year______
Has your child been baptized? Yes_______
Has your child received First Reconciliation? Yes_______
Has your child received First Communion? Yes_______
If your child received these sacraments at St. Joan of Arc, we have the information on file; if your child received any of these sacraments at another parish, please provide us with a copy of the sacramental certificate. THANKS SO MUCH.
Does your child live with: Both Parents?______ Mother only?______ Father only?_______
If not parents, with whom? (Name and Relationship) ________________________________________________________
The emergency number you give us must be different than the home or parents’ phone numbers and must be someone who can be reached during class time. We will always call the family contact numbers first, but if we can’t reach parents, the person below will be contacted:
Relationship to the child or family: ___________________________________
In the event that I, as the undersigned parent/guardian of this child, cannot be contacted,, and in the judgment of the Director of Religious Education (or the Pastor or other supervising staff or volunteer) my child requires immediate medical intervention, I hereby request and authorize the DRE or other supervising personnel to obtain for my child such medical services as are deemed necessary. I agree to assume financial responsibility for any diagnosis/treatment and for any medication deemed necessary.
Dates for which this release is intended: September 1, 2015-May 31, 2016:
On occasion, the Parish or St. Joan of Arc Religious Education Program may use photos, videos and/or classroom art or written work of students in parish publications to share information about the parish. Publications include, but are not limited to: the website, parish bulletins, annual reports, newsletters, posters, advertisements and other public relations material. In addition, local news organizations may hear of our activities or events, and our parish may invite or allow them to photograph or record our events. Names of students will NOT be released.
Please sign and check below:
_____My child’s photo, video or classroom work may be published in any format including group or individual photos.
_____My child’s photo, video or classroom work may NOT be published in any format including group or individual