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SHDHS Responsible Use Policy (RUP) Form

  • First NameLast Name 
    Please press the plus icon to add more students to the same parent information.
  • First NameLast NamePhone NumberEmail Address 
  • I hereby acknowledge receipt of the St. Henry District High School Student Handbook. I accept all rules and regulations stated in this handbook and in particular, the Drug/Alcohol/Tobacco and Photo/Video/Website Policy (enclosed).
  • I have read and accept the school’s Drug/Alcohol/Tobacco Policy on pages 19 – 22 of the Student Handbook.
  • I, (the parent/guardian mentioned above) of the student, (mentioned above) do hereby give and grant to St. Henry District High School permission to use my child’s name, photograph, and/or videotaped image in publications, video productions, and/or school website. I do further certify that I am of full legal capacity to execute the foregoing authorization and release.
  • I, (the parent/guardian mentioned above) of the student, (mentioned above) understand Saint Henry District High School's Responsible Use Policy.
  • Also, we have noticed quite a few changes on the Family Information Sheets that were part of registration last spring. On the lines below, please list any changes that may have taken place (ex. place of employment, phone numbers, emergency contacts, etc.).