Religious Education Registration form

 St. Rose Religious Education Registration Form 

FOR GRADES 1-8 ONE FORM PER FAMILY
This form is best completed on Desktop, Laptop or Tablet.  Cellphone form does not show all information.
FOR GRADES
1 thru 8
ONE FORM PER FAMILY
The form must be completed in one sitting.  Information will not be saved if you exit the page.
CHILDREN'S
INFORMATION
1ST CHILD
2ND CHILD
3RD CHILD
4TH CHILD
EMERGENCY MEDICAL AUTHORIZATION
PURPOSE
To enable parent/guardians to authorize the provision of emergency treatment for children who become ill/injured while under PREP authority, when parents can't be reached. 
This Authorization 
DOES NOT cover major surgery unless the medical opinions of two other licensed physicians or dentist, concurring in the necessity for such surger are obtained prior to the performance of such surgery.
CHILD/
CHILDREN ADDRESS
CONSENT  FORM
Please  read the agreement concerning permission of the use of  your child's photo/image
and check the appropriate box 
AGREEMENT

PLEASE COMPLETE ENTIRE FORM

Male
Female
Male
Female
Male
Female
Male
Female
I/We GRANT permission for a photo/image that includes this student without any personal identifiers to be published on St. Rose of Lima's Internet site or posted in our Church vestibule or the School.
I/We DO NOT GRANT permission for a photo/image that includes this student without any personal identifiers to be published on St. Rose of Lima's Internet site or posted in our Church vestibule or the School.

CLICK HERE TO PAY TUITION

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