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Back to School Forms

We know the beginning of the school year can be extra hectic for parents. By combining all of our necessary forms into one, we are hoping to simplify things and save you time. Please complete the following form accurately and thoroughly. Not all questions require an answer. Required fields are marked with an asterisk *

Your Student (You will need to complete a form for each student.)

Student First Name*

Answer required for "Student First Name"

Student Middle Name*

Answer required for "Student Middle Name"

Student Last Name*

Answer required for "Student Last Name"

Grade Level for 19-20*

Answer required for "Grade Level for 19-20"

Information Update

Complete the following fields only if you need to update information in Powerschool.

Mother Email

Answer required for "Mother Email "

Father Email

Answer required for "Father Email "

Mother Phone #

Answer required for "Mother Phone #"

Father Phone #

Answer required for "Father Phone #"

Student Phone #

Answer required for "Student Phone #"

Street Address

Answer required for "Street Address"

City

Answer required for "City"

State

Answer required for "State"

Zip/Postal

Answer required for "Zip/Postal"

Parent Permissions Section

Medical Treatment Authorization

This signature is requested in the event that your child becomes ill or is injured at school, at a school sponsored event, or on the way to or from school, and the school is unable to get in touch with the parents or guardians. It is understood that every effort will be made to contact he parents or guardians before any treatment is undertaken. Please check the following statement giving your consent for treatment.

Medical Treatment Authorization*

Answer required for "Medical Treatment Authorization"

I authorize treatment for my child if the child is injured or becomes ill at school.

I do not authorize treatment for my child if the child is injured or becomes ill at school.

Your name indicating your signature*

Answer required for "Your name indicating your signature"

Are there any medical considerations for your child we should know about not previously communicated to the school?

Answer required for "Are there any medical considerations for your child we should know about not previously communicated to the school?"

Handbook Agreement Form

The handbook can be found on the Bethlehem website www.bethlehemhigh.org

or at this link Bethlehem Handbook

It is available in two different formats. For Google users, the handbook is easily searchable. For non-Google users, there is a PDF option. There are new policies related to Chromebooks and attendance. Changes are highlighted in yellow.

The intent of the handbook is to communicate clearly Bethlehem's general operating procedures, services and conduct expectations and consequences to students and parents. The handbook contains recommendations from the Archdiocese of Catholic Schools and has been approved by the Bethlehem School Board. The principal retains the right to amend the handbook for just cause. Parents and students will be notified of such changes. The principal reserves the right to be the final authority for interpreting any policy concerning the school. The Bethlehem School Board requests the following statement be signed by the parent/guardian.

Handbook Agreement*

Answer required for "Handbook Agreement"

I have read the Bethlehem handbook for 2020-21 and agree to support the rules and regulations set forth therein.

Type your name indicating your consent signature.

Answer required for "Type your name indicating your consent signature."

Publications Release Form

Many of our students are recongized for their accomplishments on our website, on social media, in publication materials and in video productions. We would appreciate you giving us permission to use your child's name and/or photograph.

Publications Consent*

Answer required for "Publications Consent"

Yes, I give my consent for Bethlehem High School to use my child's name, photograph or videotaped image in printed publications, video productions, yearbook and digital media.

No, I do not give my consent for Bethlehem High School to use my child's name, photograph or videotaped image in printed publications, video productions, yearbook and digital media.

Drug Testing Consent Form (For Students participating in Sports, Competitive Events and Student Drivers)

The policy regarding drug testing is attached.

Click to read Drug Testing Policy

The undersigned student and the student's parent or legal guardian hereby acknowledges that they have read and understand the policy and agree to and are bound by the terms and conditions in the policy, including participation in related surveys.

The undersigned understand that this consent is effective for all teams/sports/organizations/on-campus driving in which the students may participate for the entirety of the current school year. The undersigned unerstand that once enrolled in the testing pool the student agrees to remain in the testing pool for the entire school year.

The undersigned hereby permit the healthcare professionals/lab selected by Bethlehem High School to perform drug testing of the student's urine and release the results to the principal of the school. Permission is also granted for the principal to release drug testing results that are positive to the coaches or organizational advisors of teams in which the student is involved.

The undersigned agrees to cooperate with the school healthcare professional in the event a prescription medication is identified through the drug testing process.

Any refusal by student participation to be tested shall be treated as a violation and the appropriate sanctions will be assessed.

Drug Testing Consent

Answer required for "Drug Testing Consent"

I have read the Drug testing Policy and give consent for my student to participate.

Type your name indicating your consent signature.

Answer required for "Type your name indicating your consent signature."

Date

Answer required for "Date"

Voluntary Drug Testing Consent Form (For students who are not driving, on sports teams, or on competitive teams)

The policy regarding drug testing is attached. The undersigned student and the student's parent or legal guardian hereby acknowledgest that they have read and understand the forgoing policy and agree to and are bound by the terms and conditions in the policy, including participation in related surveys.

The undersigned understands that their participation is completely voluntary.

The undersigned agrees to cooperate with the school healthcare professional in the event a prescription medication is identified through the drug testing process.

Any refusal by student participation to be tested shall be treated as a violation and the appropriate sanctions will be assessed.

Voluntary Drug Testing Consent

Answer required for "Voluntary Drug Testing Consent"

I have read the Drug Testing policy and give consent for my child to participate.

Type your name indicating your consent signature.

Answer required for "Type your name indicating your consent signature."

Answer Required

Free/Reduced Lunch Application

Families must apply for free/reduced lunch every year. Please mail me an application for free/reduced lunch.*

Answer required for "Families must apply for free/reduced lunch every year. Please mail me an application for free/reduced lunch."

Yes

Transportation Information

Bethlehem bus routes and times can be found on our website.

Students driving to school must purchase a $10 parking permit. These will be available to students the first week of school in their cohort.

My student will be arriving to school*

Answer required for "My student will be arriving to school"

on foot.

by car.

on Bethlehem Marion/Washington bus.

on Bethlehem Hardin County bus.

on Bethlehem Bullitt County bus.

on Nelson County Schools bus.

Other:

My student will be departing from school*

Answer required for "My student will be departing from school"

on foot.

by car.

on Bethlehem Marion/Washington bus

on Bethlehem Hardin County bus.

on Nelson County Schools bus

Other:

Grandparents Day Mass Contact Information

Grandparents are invited to attend Mass and take students out for lunch on Tuesday, September 17th. We need the addresses of the grandparents to send invitations. Please provide the addresses of anyone you would like to receive an invitation. Email Paige Montgomery, [email protected] if you'd like more than 2 invitations sent or you have additional questions about the event.

If you have multiple students, you only need to complete this section once.

Grandparent(s) #1 Address

Addressee (Example: Mr. and Mrs. Chris and Christi Christian)

Answer required for "Addressee (Example: Mr. and Mrs. Chris and Christi Christian)"

Street Address

Answer required for "Street Address"

City

Answer required for "City"

State

Answer required for "State"

Zip/Postal

Answer required for "Zip/Postal"

Grandparent(s) #2 Address

Addressee: (Example: Mr. and Mrs. Chris and Christi Christian)

Answer required for "Addressee: (Example: Mr. and Mrs. Chris and Christi Christian)"

Street Address

Answer required for "Street Address"

City

Answer required for "City"

State

Answer required for "State"

Zip/Postal

Answer required for "Zip/Postal"

Grandparent(s) Address #3

Address

Addressee: (Example: Mr. and Mrs. Chris and Christi Christian)

Answer required for "Addressee: (Example: Mr. and Mrs. Chris and Christi Christian)"

Street Address

Answer required for "Street Address"

City

Answer required for "City"

State

Answer required for "State"

Zip/Postal

Answer required for "Zip/Postal"

Grandparent(s) #4

Address

Addressee: (Example: Mr. and Mrs. Chris and Christi Christian)

Answer required for "Addressee: (Example: Mr. and Mrs. Chris and Christi Christian)"

Street Address

Answer required for "Street Address"

City

Answer required for "City"

State

Answer required for "State"

Zip/Postal

Answer required for "Zip/Postal"

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"

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