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Geibel Student-Parent Handbook Acknowledgment

To obtain a copy of the Geibel Catholic Student-Parent Handbook, please visit our website www.geibelcatholic.org.  The handbook can be viewed and printed from under the Family Resources Tab.

The student and the parent acknowledge and understand the guidelines for student behavior established by the rules and regulations set forth in the Geibel Catholic Junior-Senior High School Student-Parent Handbook.  Parents and students realize and agree that said rules and regulations form the basis for the school’s disciplinary policy and any violation of said rules and regulations shall constitute cause for disciplinary measures to be determined and implemented by the administration of the school in accordance with the handbook and the Policies and Practices of the Diocese of Greensburg.  Said disciplinary measures include detention assignment, in – or out-of-school suspension, and when necessary, expulsion.

Please select who will be participating...
Minor
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First Parent/Guardian's Name

First Name*

Middle Name

Last Name*
First Parent/Guardian's Date of Birth*
I certify that I am 18 years of age or older
First Parent/Guardian's Signature*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Student Grade Level
Please select the student's grade level.*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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