Holy Mothers Collaborative

  • Middle School Information

  • You can register up to two kids from the same family on one form.

  • Child 1

  • Gender *
  • / / Pick a date.
  • Does this child have any food allergies, medical allergies, medical conditions, etc.? *
  • Please list/explain any food allergies, medical allergies, medical conditions, etc.

  • Child 2

  • Gender *
  • / / Pick a date.
  • Does this child have any food allergies, medical allergies, medical conditions, etc.? *
  • Please list/explain any food allergies, medical allergies, medical conditions, etc.

  • Parent Information

    All of the following information is required. If there are circumstances where only one parent's information is necessary/available, please put the same name and cell phone number in BOTH parent fields.
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  • Additional Emergency Contact

    In case of an emergency, the parents/guardians will always be contacted first. Should the parents/guardians be unreachable, we will contact the Additional Emergency Contact listed below. In addition to the parents/guardians, the Emergency Contact Person is permitted to pick up and drop off your child(ren).
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  • Parent Agreement and Rules

    Please read the following in its entirety.
  • Attending Middle School Homework Day is a privilege, not a right. The following rules are to be followed at all times while your child is at Middle School Homework Day. Failure to abide by these rules will result in losing Middle School Homework Day privileges. Please share these rules with your child(ren) so that he/she knows what is expected of them. We need you, the parents, to help us out in keeping Homework Day a fun, safe place for your child(ren) each week.

    1. Parents must come downstairs to the Life House to sign their kids in and out at the start and end of Homework Day. If a parent is not the one dropping off or picking up your child, then a note of permission must be sent acknowledging who has the permission to pick up/drop off your child.

    2. The only entrance/exit that should be used to access or leave the Life House is the stairwell that leads to the hospitality room. All other doors are for emergency use only.

    3. Middle School Homework Day takes place in the Life House at St. Mary's. Kids are not permitted to leave the Life House without the permission and supervision of Mike or Tim.

    4. Kids are not permitted to enter the kitchen.

    5. Homework Day ends at 4:30 p.m. Please be on time when picking up your kids.

    6. Kids will help keep the Life House clean during Homework Day and will clean up before they leave. The Life House should be just as clean at the end of Homework Day as it was at the beginning.

    7. Respect must be shown to other kids in attendance, as well as to Mike, Tim, and their designated teen and young adult volunteers at all times.

    In checking the box below and electronically signing this form, I hereby certify that I am the parent or legal guardian of the child(ren) on this form. I confirm that the information given is correct and accurate to my knowledge, and that I have shared the Middle School Homework Day rules with my child(ren). I give permission for my child(ren) to attend this event. In case of injury or illness, I give permission for the release of medical records to an attending physician. I understand that if there is a medical emergency, every effort will be made to contact the parent(s) or guardian(s) of the child(ren) named herein. In the event that I cannot be reached, I hereby give permission to the physician attending to my child(ren) to hospitalize and secure proper and necessary treatment for my child(ren). I hereby agree that no liability is assumed by the Roman Catholic Archdiocese of Boston; St. Mary of the Sacred Heart in Hanover, MA; St. Helen Mother of the Emperor Constantine in Norwell, MA; or any employees/volunteers of the aforementioned organizations for claims, which may arise out of this event.

  • Parent Agreement *
  • / / Pick a date.