Skip to content
Mass Times
Contacts
Bulletins
Parish Office: 314-962-0038
|
parishoffice@holyr.org
2024 Auction
Our Parish
Safe Environment
Sacraments
Parish School Religion – PSR
Liturgy
Faith Formation
Athletics
Christian Service
Stewardship
Youth Ministry
Catholic Women’s League
Holy Name Society Men’s Club
School
Online Giving
5th Grade Camp Permission Form
Home
/
5th Grade Camp Permission Form
5th Grade Camp Permission Form
Molly Berra
2022-04-27T09:20:06-05:00
Permission Slip 5th Grade Camp
Permission Slip 5th Grade Camp
Dear Parent or legal Guardian:
Your son/daughter is eligible to participate in a school-sponsored activity requiring transportation to a location away from the school building. This activity will take place under the guidance and supervision of employees from Holy Redeemer School. A brief description of the activity follows:
Name of Student
*
5th Grade Camp 2022
Destination
Designated Supervisor of Activity
Date & Time of Departure
Date & Time of Return
Student Cost
Method of Transportation
Dress
Arrangements for Meals
Consent
If you would like your child to participate in the event, please complete, sign, and return the following statement of consent. As parent or legal guardian, you remain fully responsible of any legal responsibility, which may result from personal actions by the named student
Name of Student
*
List any health concerns for your child related to this trip
ACKNOWLEDGEMENT
*
I hereby consent to participation of my child in the event described above. I understand that this event will take place away from the school grounds and that 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 the participation in the event including the method of transportation.
Parent / Guardian Name
*
Emergency Phone Number
*
Parent / Guardian Signature
*
Clear
Date Signed
*
Payment
First Name on credit Card
*
Last Name
*
Email
*
Credit Card Billing Address
*
Credit Card Billing Address
Credit Card Billing Address
Credit Card Billing Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Total Cost (includes transaction fee)
*
Credit Card
If you are human, leave this field blank.
Submit
Page load link
Go to Top