Sacred Heart Villa Permission Forms for Media & Marketing, Internet Usage, Neighborhood Walking, Sunscreen for the 2025-2026 school year.

Sacred Heart Villa Permission Forms for Media & Marketing, Internet Usage, Neighborhood Walking, Sunscreen for the 2025-2026 school year.
Child's Name

First NameLast Name
Parent Email*
example@example.com
For marketing and publicity purposes, there may be times when the Archdiocese wishes to use your and/or your child/ren's image, name, recording or academic work in various media for marketing and/or publicity purposes. You may choose the appropriate levels of authorization. For your convenience, this form will cover all members of your family.

* Required field
Authorization:

Archdiocese of St. Louis: I grant permission to use my image or the image of my child/ren, name, recording, or academic work in communications that includes, but is not limited to Archstl.org, St. Louis Review, Catholic St. Louis Magazone, Archdiocesan Social Media and any publications by agencies administered by the Archdiocese of St. Louis.
Mark only one circle*

YesNo
Parish/School: I grant permission to us my or my child/ren's image, name, recording, or academic work in communications that include , but not limited to school newsletter, student newspaper, admission videos, school website and social media.
Mark only one circle*

YesNo
Secular Media Outlets: I grant permission to use my or my child/ren's image, name, recording or academic work in secular media communications including, but not limited to, print, radio, TV and internet. (ie. St. Louis Post Dispatch, KMOX radio, KMOV and KSDK-TV)
Mark only one circle*

YesNo
Internet Acceptance User Policy: My child/ren have permission to use computers during the 2025-2026 school year at Sacred Heart Villa, and/or take part in cooperative group activities with an iPad, Smart Board, or classroom computer.
Mark only one circle*

YesNo
Walking Field Trip Permission: My child/ren is eligible to participate in school sponsored walking activities away from the school grounds/building. These activities may involve walking on the sidewalks around the block or down the street, walking to Berra Park, Bocce Club, St. Ambrose and other local places on the "Hill". Children will be supervised by Sacred Heart Villa Staff during the walk.
Mark only one circle

YesNo
Sunscreen Permission: I give permission for my child/ren to have sunscreen applied by a staff member on an as to need basis while at school. I am responsible for sending in the sunscreen.
Mark only one circle

YesNo
First Child's Name

First and Middle NameLast Name
First Child's Age
Second Child's Name

First and Middle NameLast Name
Second Child's Age
Mother's Name*

First NameLast Name
Father's Name*

First NameLast Name
Parent Phone Number*
Please enter a valid phone number.
Parent Email*
example@example.com
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
A copy of your responses will be kept on file in the school office.
Should be Empty: