St. Ann's Religious Education Student Enrollment & Release Form:

Program Details
I understand that 1st Communion and Confirmation is a 2 year program*

I ACCEPT
I understand that no more than 3 absences are allowed.*

I ACCEPT
As a family we will attend family Faith Encounter events at St. Ann's*

I ACCEPT
Our family understands that weekly Mass attendance and days of obligation are required.*

I ACCEPT
Registration fee is $25.00 per child. I agree that payment needs to be made by the first day of class. Details to follow.*

I ACCEPT
Medical Dietary Questions

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING ACKNOWLEDGEMENT AND RELEASE AUTHORIZATION FOR MEDICAL TREATMENT:
Physical Condition: Please list any non-allergy physical/medical conditions that would be helpful for us to know about this child.
Medications: Please list the medications and dosage your child is currently receiving, along with any special instructions.
Food Requests: Please indicate any dietary requests due to your child’s preferences, religious practice, lactose intolerance, food sensitivity, or treatment for a behavioral condition. The following requests are NOT due to a food allergy:
Allergies: Has your child been tested and diagnosed for a food allergy by a health care professional? Is yes, please state the allergies below.
Stings: Our policy is to immediately administer diphenhydramine (Benadryl) to any student who is stung by a insect for the first time, has known allergic reactions or displays symptoms of a systemic reaction. If you choose to opt out, we will need to have a conversation before programming begins.

I ACCEPTI OPT OUTLET'S TALK MORE
Miscellaneous: Is there anything else that you believe it is important we know in regards to your child’s participation in this program? If so, please describe:

I HAVE READ THE AGREEMENT, FULLY UNDERSTAND IT, AND GRANT PERMISSION FOR MY CHILD TO PARTICIPATE IN THE PROGRAM IDENTIFIED ABOVE.
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St. Ann's Religious Education Student Enrollment & Release Form:

Parent & Guardian Information

Program Details

Medical Dietary Questions