Publicity Form 2021-2022 School Year

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This form will be used to ensure up to date parent contact information is available for all parents of high school students. If you have already completed this form for 8th or 9th grade confirmation, you do not need to complete this form again.

Parent Contact Email. * Please separate multiple addresses by commas * *

Please note, the weekly form of communication will remain on Remind. If you or your student have not joined our class, our class code is @2ag97e. You can join on the remind app or by texting 81010.

Student Last Name *

Preferred Name / Nickname

Grade in School 2021-2022 School Year

Clear selection

Is the student registered at St. Malachy Parish?

Yes

Clear selection

If no, which parish does the student belong to? (Name and city)

Please list parent/guardian's names

Videotaping & Still Photography Permission Form. *

On occasion, St. Malachy Parish and/or Youth Ministry and/or the Diocese of Peoria, takes photographs or makes audio/ video/ digital recording of the participants involved in parish activities. Such photographs or video/digital recordings may be used by staff and participants to remember the activities or participants. In addition, such photographs and audio / visual / digital recordings may be used in St. Malachy Parish / Youth Ministry and/ or Diocesan publications or advertising materials to let others know about our school/parish/Diocese. In addition, local news organizations may hear of our activities or events, and our school/parish/Diocese may invite or allow them to photograph or record our events to be used, distributed, or displayed, as agents of the school/parish/Diocese see fit. This consent includes but is not limited to: photographs, video/digital recordings, and audio recordings.

Yes

Please type your name as your electronic signature and acknowledgment of Videotaping & Still Photography Permission Form. *

Submit

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