Test Form Scroll Down Please enable JavaScript in your browser to complete this form. – Step 1 of 5 Student Release Authorization 2022-2023I do hereby authorize St. Mary’s Catholic School to release my child(ren),Parent/Guardian Name *FirstLastStudent Name *FirstLastGrade *Student NameFirstLastGradeStudent NameFirstLastGradeStudent NameFirstLastGradeto the following individual(s), on the annotated days:NameFirstLastFromToAll YearName FirstLastFrom To All YearName FirstLastFrom To All YearName FirstLastFrom To All YearName FirstLastFrom To All YearChecking “All Year” is authorizing that individual to pick-up your child at anytime during the school year.NextExtended Care Programs2022-2023 St. Mary’s Catholic School provides care outside of school hours for students enrolled in our school. Students are enrolled in the program by completing a Morning Care Enrollment Form/After Care Enrollment Form. Morning Care – 7:00a.m. – 7:30a.m. $60.00 per child per month OR $3.50 per child per day After Care – 3:00p.m. – 6:00p.m. $200.00 per child per month OR $0.10 per child per minute Late FeeIf your child is not picked up by 600p.m. you will be charged a late fee of $2.00 per minute per child per day. Payments are due upon receipt of receiving your bill for Morning and After Care Early Childhood/Extended Care Special Policies Illness The primary concern of St. Mary’s Catholic School is to provide a healthy, safe environment for students and staff. Please keep your children home if they exhibit any symptoms that could be contagious. It will be at the discretion of the staff person in charge to determine if a student needs to be sent home for illness. Students must be fever free for 24 hours in order to be at school. Behavior Potty Trained:All children who participate in the pre-school and extended care programs must be totally potty trained. Please refer to Student/Family Handbook for guidance. Discipline:Students are expected to respect staff members as well as other children. Please refer to the Student/Family Handbook for guidance. NextMorning Care Enrollment Form2022-2023St Mary’s Catholic School provides care outside of school hours only for students enrolled in our school. Payments are due upon receipt of receiving your bill for Morning Care students. Student's NameFirstLastGradeStudent's NameFirstLastGradeStudent's NameFirstLastGradeFull time – $60/child/monthDrop in – $3.50/child/dayIf a sudden illness or other serious medical emergency should occur and I cannot be reached, I hereby authorize St. Mary’s Catholic School Morning care to phone my child’s physician or dentist or to take my child to the nearest medical facility for medical treatment. I authorize any licensed physician or medical center to treat my child. SignatureDateAfter Care Enrollment Form2022-2023St Mary’s Catholic School provides care outside of school hours only for students enrolled in our school. Payments are due upon receipt of receiving your bill for Morning Care students. Student's NameFirstLastGradeStudent's NameFirstLastGradeStudent's NameFirstLastGradeFull time – $200/child/month Drop In – $0.10/child/minute/day A late fee of $2.00 per minute will be charged per child per day if not picked up by 6:00p.m.If a sudden illness or other serious medical emergency should occur and I cannot be reached, I hereby authorize St. Mary’s Catholic School Morning care to phone my child’s physician or dentist or to take my child to the nearest medical facility for medical treatment. I authorize any licensed physician or medical center to treat my child. SignatureDateBy signing above, I acknowledge my child(ren) must be picked up from After Care by 6:00 p.m.NextWalking Field Trip Form2022-2023Due to our physical location, St. Mary’s Catholic School students often have an opportunity to participate in educational opportunities at the library and Cathedral. You will be notified of the event, purpose, destination, date and time of departure, and estimated time of return in advance allowing you the opportunity to disapprove your student’s participation if you so choose. Students without an approved and signed permission form may not participate in the field trip. Your son/daughter/guardianship must be eligible at the time of the field trip to participate in a school-sponsored activity that requires they be absent from the school grounds and classes.The activity will take place under the guidance and supervision of St. Mary’s Catholic School Faculty.Activity: Walking Field Trip Destination: Laramie County Library or St. Mary’s Cathedral or Civic Commons Park Designated supervisor: St. Mary’s Catholic School Faculty Date/Time of departure: To Be Announced Date/Anticipated Time of return: To Be Announced Method of Transportation: Walking Student Cost: To Be Announced(if needed)If you would like your child to participate in this event, please complete this statement of consent and release of liability. As parent or legal guardian, you remain fully responsible for any legal responsibility that may result from any personal actions taken by the named student.I hereby consent to participation by my child: in the event described above. I understand this event will take place away from school grounds and my child will be under the supervision of the designated school employee on the stated dates. i further consent to the conditions stated above on participation in this even. Parent's SignatureEmergency Phone NumberAddressI hereby authorize St. Mary’s Catholic School to take my child for medical treatment int he event of an emergency in which neither parent can be reached. I authorize any licensed physician or medical center to treat my child.SignatureDateNextPhotograph and Video Consent Form2022-2023From time to time, pictures and video may be taken of youth ministry, religious education and/or school events and gatherings. we would like to be able to use these photographs and videos for flyers, parish and diocesan publications, and the ministry websites or social networking sites. Written consent of both the student and parent/guardian is required. Names will not be posted unless written authorization is given by the the student and parent/guardian, and then only first names will be used. If there are concerns about pictures or videos posted on the website or social networking site, please contact the ministry coordinator or webmaster, and they will be promptly removed.I/we, the parent(s)/guardian(s) of this youth (name) authorize and give full consent, without limitations or reservation, to St. Mary’s Parish/St. Mary’s Catholic School, to publish any photograph or video in which the above named student appears while participating in any program associated with St. Mary’s Parish/St. Mary’s Catholic School ministry. There will be no compensation for use of any photograph or video at the time of publication or in the future.Student SignatureDate Parent/Guardian SignatureDate Parent/Guardian SignatureDate Submit
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