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I/ We, hereby declare that the choice to send my son/ daughter to the Catechism School of St. Alphonsa
Cathedral under the Department of Catechesis, Eparchy of Mississauga is made by me/ us willingly and
consciously and was not forced by anyone.
I/We hereby declare that I/ we am/are the parent(s) or guardian(s) of the child named above. I have
read and understood the information provided on this form in its entirety and hereby consent to
participate being aware of all the foregoing.
Catechism School of St. Alphonsa Cathedral, Mississauga and the Department of Catechesis, Eparchy of
Mississauga is requesting your permission to use your child’s information (i.e., Name and Grade, image,
video, or any creative content presented by the child) in:
These activities/ programs/ competitions may be presented/ published/ posted in print and/or digital
media/ virtual platforms including Parish or Eparchial publications, reports, notice board, yearbooks.
newsletters and online virtual platforms.
Such works may also include video recordings or display of images, where the faithful community and/or
public may have access to this information and may identify you or your child.
In case of any privacy or safety concerns, we agree to contact the Parish Priest or Catechism Principal of
St. Alphonsa Cathedral, Mississauga.
By signing this form and submitting it to the Catechism School of St. Alphonsa Cathedral, Mississauga,
you are consenting to your child’s information being used for the stated purposes.
Yes, I/ We consent to my child’s information being used for the above stated purposes.