2022-23 Student Release Form

2022-23 Student Release Form

Contact Info, medical info & release (in the event of an emergency), safety/parent pickup info, and media release form
  • Date Format: MM slash DD slash YYYY
  • First emergency contact while student is in faith formation, under the care of an adult leader.
  • If unable to make contact with Parent or Guardian.
  • Is this adult a grandparent, relative, caregiver or other
  • In the interest of safety and our ongoing efforts to protect children as outlined in the diocesan Safe Environment program, we ask that a parent or designated adult bring children to our faith formation sessions and pick them up. We cannot be responsible for the safety of unattended children before entering or upon leaving our buildings, especially during the dark winter afternoons/evenings or inclement weather. Besides you, who is allowed to pick up your child when sessions are ended?
  • We will not release your child to anyone not listed above. Please notify the adult leader of any changes to the list during the year. Who is NOT ALLOWED to pick up your child from faith formation sessions? (please list if applicable)