HCREA PERMISSION FOR ENROLLMENT
Release Time Religious Instruction During School Hours
Student Information
First Name
Last Name
Gender
Please Select
Male
Female
Birthday
Graduation Year
Is Your Child Homeschooled?
Please Select
Yes
No
Name of School Student Attends
Grade
Homeroom Teacher
Parent/ Guardian Information
Full Name
Email
example@example.com
Relationship to Student
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Are there any custody arrangements or no contact orders we should be aware of?
If Yes, Please Explain
If your child needs special accommodations, please list them below..
Does your child have any allergies?
If Yes, Please List
Do you consent to the photography or video of your Student attending Religious Education, for promotional purposes?
Please Select
Yes
No
Please Sign Below to Acknowledge the Agreement of this Form
Continue
Continue
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