D-2 Grades 4-6 Code of Conduct Agreement - Sts Joseph & Paul Catholic Church

It is the responsibility of the parent/guardian to explain this Code of Conduct to their child.
Consent of YOUTH PARTICIPANT/STUDENT*
I understand that any action inconsistent with this Code of Conduct may result in appropriate disciplinary action.

I agree to the terms stated above.
YOUTH PARTICIPANT/STUDENT*
First Last
Date
MM slash DD slash YYYY
Consent of Signature of Parent / Legal Guardian*
1. By signing this, I acknowledge that photographs/videos of my child may be used for the purpose of publication. If I do not want my child photographed for such purpose, I am responsible for notifying the program organizer in writing. 2. Diocesan policy states that “no one should be left alone in a supervisory capacity. There should always be a minimum of two Safe Environment-cleared adults” present. Parent(s)/guardian(s) are to ensure that child arrives and is picked up at designated times to avoid violation of this policy. For school events if the teacher, staff contact, or an adult supervisor is in attendance, that person should keep this form. If youth are not accompanied by school representative, then forms should be forwarded to appropriate school office PRIOR to event.

I understand and agree with the terms stated above.
Signature of Parent / Legal Guardian Date*

First Last
Date
MM slash DD slash YYYY
Name
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