Opt Out Form- MHS Family Roster

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Email *

Daughter's first and last name *

I do not want the following information published in the Mercy High School Roster. (Please click all that applies) *

Family name (Parent First and Last Names)

Name and grade of daughter(s)

Home phone number

Parent cell phone number(s)

Home address and city

Parent/ Guardian Email #1 (Mom)

Parent/ Guardian Email #2 (Dad)

Other Parent/ Guardian Email listed

All of the above- remove me completely from the Mercy High School Roster

Required

I understand that the information listed above will not be included in the Mercy High School Roster and as a result I may not be included in class communication initiated from parents *

Yes

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