1. Healthcare

All Saints Catholic School
Parent Information—Week of February 2, 2015
MONDAY, FEBRUARY 2
Free Dress Day
Students may wear free dress today. Please consult the handbook for free dress guidelines.
Current Family Enrollment Begins
Current families may begin submitting their enrollment forms today. Forms must include the $150 registration
fee.
7/8 Grade Academic Bowl ABLE Team Practice/7:45 a.m./Room 112
The 7/8 grade ABLE team will practice this morning.
Rise and Shine Assembly/8:30 a.m./Gym
Mrs. Krawczyk’s class will lead this week’s Rise and Shine assembly. Parents are always welcome to join us in
the gym.
After-School Clubs/3:30-4:30 p.m.
Mad Science will meet in Room 108.
TUESDAY, FEBRUARY 3
5th Grade Field Trip/1:00 p.m./AVB
The 5th graders will visit Arkansas Valley Bank today as they begin preparations for BizTown.
After-School Clubs/3:30-4:30 p.m.
Bricks 4 Kidz will meet today in Room 305. Cheer Practice will meet in the Parish Hall today.
WEDNESDAY, FEBRUARY 4
7/8 Grade Academic Bowl ABLE Competition/3:30 p.m./Metro Christian
The 7/8 grade Academic Bowl ABLE team will compete at Metro Christian today.
After-School Clubs/3:30-4:30 p.m.
Tippi Toes will meet in Room 111.
THURSDAY, FEBRUARY 5
Honor Choir/7:40 a.m.
Honor Choir members should meet in the Music Room on Thursday morning.
5th Grade Field Trip/11:40 a.m./Gilcrease Museum
The 5th graders will visit the Gilcrease Museum today.
After-School Clubs/3:30-4:30 p.m.
Young Rembrandts will meet in the Art Room.
Challenge Girls Open House/6:30-8:00 p.m./Church of Saint Benedict
Challenge Girls of Broken Arrow is having an open house tonight. Girls from 4th-12th grade are welcome to
attend. For more information please email [email protected].
MORE →
FRIDAY, FEBRUARY 6
7/8 Grade Academic Bowl ABLE Team Practice/7:45 a.m./Room 112
The 7/8 grade ABLE team will practice this morning.
Mass/9:30 a.m./St. Anne’s Church
Mrs. Oldham’s 1st graders will be the Mass leaders today. Students must wear their Mass uniforms. Parents
and visitors are always welcome to join us; we ask that you sit in the chapel area.
Spelling Bee/1:00 p.m./Parish Hall
The all-school Spelling Bee will be held this afternoon in the Parish Hall. Parents are welcome to attend.
After-School Clubs/3:30-4:30 p.m.
Steps to the Stage will meet in Room 114.
All Saints Trivia Night/6:00 p.m./Parish Hall
The All Saints Trivia Night will begin tonight at 6:00 p.m. with dinner, following by the trivia competition.
SATURDAY, FEBRUARY 7
Mathcounts Regional Competition/8:00 a.m./University of Tulsa
Top students will compete at this morning’s competition.
YPAE Arts Awards Ceremony/12:00 p.m./OKC
Students will be recognized today for their art on display in OKC.
KofC Free Throw Contest/2:00 p.m./Gym
Boys and girls aged 10-14 are invited to participate in the Knights of Columbus Free Throw contest today.
Ties and Tiaras Dance/6:30-8:30 p.m./Parish Hall
The Ties and Tiaras Dance will be tonight in the Parish Hall.
REMINDERS
ONLY 5 TABLES LEFT for the 2nd All Saints Trivia Night is coming up Friday, February 6. Doors will open
at 6:00 p.m. in the Parish Hall. Tables of 8 are being sold for $200, which includes a chuckwagon meal. To
purchase a table or volunteer to help contact Penny Patton ([email protected]).
A new BoxTops Contest has started! The class that collects the most BoxTops between now and February 27
will win a Pizza Party from Marco’s Pizza.
Mrs. Olinghouse is looking for lunch workers. Email her at [email protected] if you can help.
Junior Comet Lacrosse sign-ups
K-8th grade boys
December 19th – February 4th
Season Dates:
February 9th practice starts
Games on Saturdays March 7th- May 17
K-2 will practice two days a week
th
th
4 -8 grade will practice three times a week
All practices will be located on the west fields at
Bishop Kelley High School.
Register Online:
www.sportabase.com
Indian Nations Youth Conference with 12 local teams
Registration Fees including uniform - $200
If you have a uniform from last year the fee will be $150
Uniforms are standard youth and adult sizes
Interested in Coaching
training provided NO lacrosse experience needed
Please Contact
Christy Rawlings
[email protected]
Cell 918-284-1000
Diocese of Tulsa
Robbers Cave State Park
COST: $200
Registration Opens January 28, 2015 / Closes April 30, 2015
$100 Non-Refundable Deposit Due Upon Registration / $100 Balance Due by April 30, 2015
Participant’s Name:
Parish/School:
Grade: _______ Date of Birth: ___________Age: _____ Girl/Boy:______
Address:
City/State: _______________________ Zip: ___________
Participant resides with (check all that applies): Mother  Father 
Guardian(s)
Custodial Parent/Legal Guardian’s Name:
Address:
City/State: _______________________ Zip: ___________
Phone (H): (_____)____________________ (W) (_____)___________________ (C) (_____)
Email:
Emergency Contact:
Relationship: ______________________________
Home Telephone: (_____)__________________ Work (_____)_________________ Cell (_____)
2nd Emergency Contact:
Relationship: ______________________________
Home Telephone: (_____)__________________ Work (_____)_________________ Cell (_____)
T-shirt Adult Sizes:
S
M
L
XL
2XL ($2 extra)
 Session I: June 22-June 26, 2015: Entering Grades 4-5
 Session II: June 29-July 3, 2015: Entering Grades 6-8
I will need bus transportation to Robbers Cave State Park:
Departing: Yes 
No 
Returning: Yes 
No 
Is this your child’s first time away from home for an extended period of time? Yes  No 
Please let us know anything we should be aware
of about your child that will help us make camp a more enjoyable experience for them (i.e. certain fears, dislikes, behaviors, etc.)
REQUIRED OFF-SITE CONSENT AND WAIVER FORM for YOUTH ACTIVITIES
Name of Activity: Diocese of Tulsa Catholic Summer Camp (hereinafter referred to as the Activity and more fully described below). Please print
PARTICIPATION PERMISSION: I, the undersigned, am custodial parent/legal guardian of Participant and request that he/she be to allowed participate in the Activity
to be held at Robbers Cave State Park located near Wilburton, Oklahoma on June 22-26 or June 29-July 3, 2015, including travel time and all events and activities
related to said Activity. Transportation is being provided by the Diocese of Tulsa. I understand that in the event Participant fails to conduct herself/himself in a
manner consistent with the policies of Diocese of Tulsa, she/he may be requested to leave the Activity and return home at my expense and that additional
disciplinary action may result.
LOST OR STOLEN ITEMS: I hereby understand and agree that neither the Diocese of Tulsa nor any of their respective employees, directors, officers, agents,
representatives and/or volunteers shall be held liable for any of my or my child’s personal property lost or stolen during participation in the Activity.
MEDICAL INFORMATION: Is Participant taking any medications OR have any medical conditions (e.g., diabetes, epilepsy, heart conditions, etc.)
 yes  no If yes, explain (attach additional sheets as necessary):
Does your child have any allergies? (e.g., insects, hay fever, strawberries, peanuts, etc.)  yes  no If yes, explain (attach additional sheets as necessary):
Does your child have any allergies or adverse reactions to medications? (e.g., penicillin, ibuprofen, acetaminophen, etc.)  yes  no If yes, explain (attach
additional sheets as needed):
Does your child have any disabilities or physical or developmental limitations?  yes  no If yes, explain (attach additional sheets as necessary):
Participant’s Primary Physician:
Telephone: (_______)___________________
Health Plan Carrier:
Group#: ____________________ Policy#:___________________
Name of primary insured:
Date of last tetanus immunization: ___________________
_______ (Parent Initial)
REQUEST AND AUTHORIZATION TO ADMINISTER MEDICINES: I request and authorize the staff of the Activity to administer the medicines listed below to
Participant, as indicated:
Name of Medicine
Dosage
Frequency
1.
2.
________________________________________________________________________________________
________________________________________________________________________________________NOTE: ALL MEDICINES TO BE TAKEN
OR ADMINISTERED MUST BE ARRANGED FOR IN ADVANCE AND MUST BE PROVIDED IN THEIR ORIGINAL PHARMACY CONTAINER,
INCLUDING THE PARTICIPANT’S NAME AND DOCTOR’S INSTRUCTION. (Attach extra pages if necessary)
I hereby grant  do not grant  permission for non-prescription medication (such as non-aspirin products, i.e., acetaminophen or ibuprofen, throat lozenges, etc)
to be given to Participant, if deemed appropriate.
Parent/Guardian Signature: ___________________________________________
Date__________________
CONSENT TO TREATMENT OF PARTICIPANT: I am the custodial parent or legal guardian of Participant. I hereby warrant that to the best of my knowledge,
Participant is in good health and physically able to participate in the Activity and I assume all responsibility for the health and physical condition and ability of
Participant to so participate.
In the event of circumstances that indicate that Participant is in need of immediate medical care, I authorize and give permission for Participant to be transported to a
hospital/clinic/medical facility for evaluation and emergency medical or surgical treatment, including any necessary X-ray examination. I authorize any licensed
physician or medical center to treat Participant. I accept full responsibility for any medical or hospital bills associated with the care of Participant.
LIABILITY WAIVER: In consideration of the arrangement set forth herein, I do on behalf of myself, Participant and our respective heirs, successors, assigns and next
of kin, release, waive, hold harmless, defend and covenant NOT TO SUE or pursue any legal action against the Bishop of the Diocese of Tulsa, and the Diocese
of Tulsa and each of their respective departments, directors, administrators, teachers, officers, agents, representatives, volunteers and employees from any and all
actions, claims, demands or liabilities, including without limitation, those for personal injuries or property damage, that I and/or Participant may suffer due to illness or
injury suffered by Participant as a result of, or in connection with, participation in the Activity, including the administration of authorized medications, medical
treatment and any consequences that may arise as the result of said treatment, including without limitation, travel to and from the Activity, housing, meals and
collateral entertainment to the fullest extent permitted by law.
USE OF IMAGE WAIVER: I hereby grant the parish and/or the Diocese of Tulsa permission to use my child’s image and likeness in any television broadcast,
photograph, video, internet site, audio-recording, and in any and all of its publications, including website entries (collectively “promotional materials”) without payment
or any other consideration. I understand and agree that these promotional materials will become the property of the parish and/or the Diocese of Tulsa and will not be
returned. I hereby irrevocably authorize the parish and/or the Diocese of Tulsa to edit, alter, copy, exhibit, publish or distribute my child’s image or likeness for
purposes of publicizing or promoting the parish and/or the Diocese of Tulsa’s programs, or for any other lawful purpose. In addition, I waive the right to inspect or
approve the finished product, including written or electronic copy, wherein my own/my child’s likeness appears. Additionally, I waive any right to royalties or other
compensation arising or related to the use of the promotional materials.
_______(Parent Initial)
CONDUCT POLICY: I hereby acknowledge the participant is to maintain conduct in a manner consistent with the policies of the parish and/or the Diocese of Tulsa. I
understand that failure to do so may result in my child being required to leave the youth activity and/or to discontinue participation in future youth programs and
activities at the discretion of the parish, school, and/or the Diocese of Tulsa. Understanding this, my child and I commit to the following (Parent/Participant 12 years
of age and older initial each):
______/_____ My child will not possess, obtain, use, or abuse alcohol, tobacco, or and other illegal substances. I understand that failure to abide by
this rule will result in my child’s immediate dismissal from the youth activity. I also understand that if my child is dismissed, he or she will be sent home
at my (parent’s or guardian’s) expense. I further understand that my child may be required to discontinue participation in future youth activities at the
discretion of the parish, school, and/or the Diocese of Tulsa.
______/_____ My child will not possess, obtain, or use a weapon of any kind, including pocket knives. I understand that failure to abide by this rule will
result in my child’s immediate dismissal from the youth activity. I also understand that if my child is dismissed, he or she will be sent home at my
(parent’s or guardian’s) expense. I further understand that my child may be required to discontinue participation in future youth activities at the
discretion of the parish, school, and/or the Diocese of Tulsa.
______/_____ My child will maintain decorum and discipline. I understand that, should a discipline problem arise and my child is involved, my child will
be immediately dismissed from the activity. I also understand that if my child is dismissed, he or she will be sent home at my (parent’s or guardian’s)
expense. I further understand that my child may be required to discontinue participation in future youth activities at the discretion of the parish, school,
and/or the Diocese of Tulsa.
I certify to you that the information contained herein is true and correct to the best of my knowledge and that I fully understand the terms and legal
consequences of my execution of this REGISTRATION CONSENT AND WAIVER FORM FOR YOUTH ACTIVITIES consisting of two (2) pages.
Participant’s Signature (12 years and up):
Date_______________
Custodial Parent/Guardian Name (please print):
Custodial Parent/Guardian Signature:
Method of Payment:
 Check payable to “Diocese of Tulsa Youth Office”
 Credit Card; Provide following Credit Card Information 
Mail complete registration, liability, and copy of insurance cards to:
Diocese of Tulsa
ATTN: Summer Camp
PO Box 690240
Tulsa, OK 74169-0240
Questions?
918/307-4939 or 918/307-4940
[email protected]
Date_______________
 Visa
 MasterCard
AmEx
 Discover
Name on Credit Card: _____________________________
Billing Address: __________________________________
City: ________________ State: ________ Zip: _________
Card Expiration Date: Month ______ Year ________
Credit Card Number: _______-_______-_______-_______
Total Billed to Card: $________
Account: 627-SC