Loretto Homeschool Ministry Registration

Email

This field is for validation purposes and should be left unchanged.

Date of Registration*

Mother's Name*

First Middle Last

Mobile Phone*

Primary Email*

Father's Name

First Middle Last

Mobile Phone

Personal Email

I would like to register for: (check all that apply)*

Loretto
Annunciation
Teen Dance

Home Parish*

Child's Information

How many children are you registering for Loretto?*

Name of Child #1*

First Middle Last

Gender*

Date of Birth*

School attending this year*

Permission to Contact Youth

I hereby grant permission for Mary Our Queen to contact my child, for internal or external communications until May 31,2027 via social media, email, text, and/or parish/school-approved online/virtual platforms. I understand I can request the same communications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can receive it in a printed form or by an email list).

I DO NOT GRANT PERMISSION TO CONTACT

Student Email

Student Cell

Does your child have any allergies or health concerns that we need to know about?*

Does your child have any drug allergies? Please list below*

I hereby grant permission for non prescription medication to be given, if deemed appropriate*

Yes
No

Media Policy

Mary Our Queen uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.
I hereby grant permission for Mary Our Queen to use images and interviews of my child for internal or external communications.

I DO NOT AGREE TO THE MEDIA POLICY

Name of Child #2*

First Middle Last

Gender*

Date of Birth*

School attending this year*

Permission to Contact Youth

I hereby grant permission for Mary Our Queen to contact my child, for internal or external communications until May 31,2027 via social media, email, text, and/or parish/school-approved online/virtual platforms. I understand I can request the same communications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can receive it in a printed form or by an email list).

I DO NOT GRANT PERMISSION TO CONTACT

Student Email

Student Cell

Does your child have any allergies or health concerns that we need to know about?*

Does your child have any drug allergies? Please list below*

I hereby grant permission for non prescription medication to be given, if deemed appropriate*

Yes
No

Media Policy

Mary Our Queen uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.
I hereby grant permission for Mary Our Queen to use images and interviews of my child for internal or external communications.

I DO NOT AGREE TO THE MEDIA POLICY

Name of Child #3*

First Middle Last

Gender*

Date of Birth*

School attending this year*

Permission to Contact Youth

I hereby grant permission for Mary Our Queen to contact my child, for internal or external communications until May 31,2027 via social media, email, text, and/or parish/school-approved online/virtual platforms. I understand I can request the same communications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can receive it in a printed form or by an email list).

I DO NOT GRANT PERMISSION TO CONTACT

Student Email

Student Cell

Does your child have any allergies or health concerns that we need to know about?*

Does your child have any drug allergies? Please list below*

I hereby grant permission for non prescription medication to be given, if deemed appropriate*

Yes
No

Media Policy

Mary Our Queen uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.
I hereby grant permission for Mary Our Queen to use images and interviews of my child for internal or external communications.

I DO NOT AGREE TO THE MEDIA POLICY

Name of Child #4*

First Middle Last

Gender*

Date of Birth*

School attending this year*

Permission to Contact Youth

I hereby grant permission for Mary Our Queen to contact my child, for internal or external communications until May 31,2027 via social media, email, text, and/or parish/school-approved online/virtual platforms. I understand I can request the same communications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can receive it in a printed form or by an email list).

I DO NOT GRANT PERMISSION TO CONTACT

Student Email

Student Cell

Does your child have any allergies or health concerns that we need to know about?*

Does your child have any drug allergies? Please list below*

I hereby grant permission for non prescription medication to be given, if deemed appropriate*

Yes
No

Media Policy

Mary Our Queen uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.
I hereby grant permission for Mary Our Queen to use images and interviews of my child for internal or external communications.

I DO NOT AGREE TO THE MEDIA POLICY

Name of Child #5*

First Middle Last

Gender*

Date of Birth*

School attending this year*

Permission to Contact Youth

I hereby grant permission for Mary Our Queen to contact my child, for internal or external communications until May 31,2027 via social media, email, text, and/or parish/school-approved online/virtual platforms. I understand I can request the same communications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can receive it in a printed form or by an email list).

I DO NOT GRANT PERMISSION TO CONTACT

Student Email

Student Cell

Does your child have any allergies or health concerns that we need to know about?*

Does your child have any drug allergies? Please list below*

I hereby grant permission for non prescription medication to be given, if deemed appropriate*

Yes
No

Media Policy

Mary Our Queen uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.
I hereby grant permission for Mary Our Queen to use images and interviews of my child for internal or external communications.

I DO NOT AGREE TO THE MEDIA POLICY

Name of Child #6*

First Middle Last

Gender*

Date of Birth*

School attending this year*

Permission to Contact Youth

I hereby grant permission for Mary Our Queen to contact my child, for internal or external communications until May 31,2027 via social media, email, text, and/or parish/school-approved online/virtual platforms. I understand I can request the same communications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can receive it in a printed form or by an email list).

I DO NOT GRANT PERMISSION TO CONTACT

Student Email

Student Cell

Does your child have any allergies or health concerns that we need to know about?*

Does your child have any drug allergies? Please list below*

I hereby grant permission for non prescription medication to be given, if deemed appropriate*

Yes
No

Media Policy

Mary Our Queen uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.
I hereby grant permission for Mary Our Queen to use images and interviews of my child for internal or external communications.

I DO NOT AGREE TO THE MEDIA POLICY

Parent Signature*

I have read and understand all consents for each child I wish to register.