One Final Step

Please complete an Emergengy & Disaster Preparedness Form.

Family Name*
Parent/Guardian 1 Name*
First Last
Contact Phone*
Parent/Guardian 2 Name*
First Last
Contact Phone*
Children Enrolled in REP Classes
Child 1*
First Last
Child 1 Grade*
Child 2
First Last
Child 2 Grade
Child 3
First Last
Child 3 Grade
Child 4
First Last
Child 4 Grade
Please choose one of the following
- In a disaster or emergency situation, I wish my child/children to be released only to the parent or legal guardian listed above.
- In a disaster or emergency situation, I authorize St. Thomas More Religious Education Program to release my child/children to any of the following (if parent or legal guardian cannot be reached) to provide emergency transportation.
Adult 1
First Last
Adult 1 Phone
Adult 2
First Last
Adult 2 Phone
I understand that St. Thomas More and/or the STM Religious Education Program do not assume responsibility for any medical or dental payment(s). However, in an emergency St. Thomas More and/or the STM Religious Education Program may choose a duly licensed physician, ambulance company, or dentist to provide emergency medical and/or dental care for the child(ren) listed above on this form.
Signature

Thank you for submitting your registration for the St Thomas More Religious Education Program.

An Email has been sent to confirm your registration. If you have not received this email after 1 business day, please contact the REP office during normal business hours.

One Final Step

Children Enrolled in REP Classes