PARENT OPTION FORM

St. Joseph’s believes that it is vitally important to take steps to ensure that our environment is safe so that we may provide a good experience for young people. We are providing adults and children with materials and information that will help ensure safety.

Our Archdiocesan "Protecting Children and Youth Initiative" requires that all children in parish formation programs and their parents (if indicated) attend these sessions. If you would like, you can request to opt out but in doing so you understand that you will make every effort to educate your children about personal safety in the way you deem appropriate.

Please complete, sign and return this form if you have decided for any reason that your child(ren) will not participate in a PCYI activity.

This form is to be completed if you are choosing to assume full responsibility for educating your child about personal safety.

I do not wish for my child(ren) to participate in:

Please check the program that you have chosen not to attend.

o Safe and Sacred Spaces (Grade 9) (Classroom Session)

Wednesday, December 19, 7:00-8:30 pm

o Safe and Sacred Spaces (Grade 10) (Classroom Session)

                        Wednesday, March 26 – 7:00-8:30 pm

o Out of Harm’s Way (Grades 5-8) Youth Only (Classroom sessions)

Grades 5-6 – Monday, March 3, 5:30-6:30 pm or 7:00-8:00 pm OR

                    Wednesday, March 5, 5:30-6:30  pm

Grade 7 – Wednesday, April 16, 7:00-8:30 pm

Grade 8 - Wednesday, November 7, 7:00-8:30 pm

o Family Safety Event (Age 4- Grade 4) Parent/Guardian and Child

Saturday, February 23, 10:00 am-1:30 pm

Child’s Full Name _________________________________________ Grade Level_________

(Please print)

Child’s Full Name _________________________________________ Grade Level_________

(Please print)

Child’s Full Name _________________________________________ Grade Level_________

(Please print)

Child’s Full Name _________________________________________ Grade Level_________

(Please print)

In choosing to have my child excused from these classes/sessions, I understand that it is MY RESPONSIBILITY to share with my child personal safety rules I deem appropriate.

Parent Name______________________________________________

(Please print)

Parent Signature___________________________________________Date_________________