2023-2024 Consent for Electronic Communications with Minors

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

DISCLOSURE, AUTHORIZATION AND CONSENT FOR SOCIAL MEDIA OR OTHER ELECTRONIC COMMUNICATION INVOLVING MINORS

In order to ensure transparency and parental involvement, St. Joseph Parish & School has created this consent form so that parents and guardians may provide authorization for St. Joseph Parish & School leaders to electronically communicate with minors. Such communications must comply with applicable St. Joseph Parish & School, including restrictions on private communications with minors.

I grant permission for staff or other leaders of St. Joseph Parish & School to communicate with My Child electronically. I understand that such communications are for St. Joseph Parish & School purposes only and may involve group communications relating to St. Joseph Parish & School activities. Further, I understand and authorize that such electronic communications may be made via text, email, telephone and cell phone, social media, digital networking, and other electronic means.

I acknowledge that to review or receive public communications shared via social media with My Child, I will need to have an account with the same social media platforms or become a fan or follower of the same social media. I also understand that communications may be accessible or viewable by others who are also fans or followers of the same social media.

This Disclosure, Authorizations, and Consent form is valid for one year (July 1, 2023 - June 30, 2024).

If I choose to rescind this authorization and consent, I agree that I will inform St. Joseph Parish & School in writing and that this rescission will not take effect until it is received by St. Joseph Parish & School.

YOUTH's First Name *

YOUTH's Last Name *

I am the parent or legal guardian of ____________________________ (full name of minor) (“My Child”). *

I have read the above Disclosure, Authorizations, and Consent, have had the opportunity to consider their terms, and understand them. I execute this document voluntarily and with knowledge of its significance. *

YES

Parent/Guardian Full Name (First & Last) *

Parent/Guardian Main Phone Number *

Home Address *

Parent/Guardian Email Address *

Teen's Email Address (please list all teens' email addresses you wish for St. Joseph Parish & School to use for communications). {Teen emails will be used to provide updates on events, links to key resources, zoom meeting information if applicable, etc.} If you desire all communication to filter through a parent email, please write "Parent Email Only." *

Teen's Cell Phone Number (please list teens' cell phone numbers for St. Joseph Parish & School to use for communications via FlockNote). {Teen cell phone numbers will be used to provide reminders, updates on events, links to key resources, zoom meeting information if applicable, etc.} If you desire all communication to filter through a parent cell, please write "Parent Cell Only." *

I acknowledge that I am aware of my actions and intent to sign. I give consent indicating that I agree to allow the transaction to take place electronically. *

YES

Parent/Guardian Electronic Signature & Date *

Please type your full name to "sign" Electronically as well as the date.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms