Elementary Record Release Authorization Name of School: Corpus Christi, ManhattanDivine Mercy, New WindsorHoly Family, New RochelleNativity of Our Blessed Lady, BronxOur Lady of the Assumption, BronxOur Lady of Perpetual Help, PelhamOur Lady of Pompeii, ManhattanOur Lady of Mount Carmel - St. Benedicta, Staten IslandSacred Heart, SuffernSt. Adalbert, Staten IslandSt. Ann, YonkersSt. Elizabeth Ann Seton, Shrub OakSt. John, BronxSt. Joseph - St. Thomas, Staten IslandSt. Luke, BronxSt. Patrick, BedfordSt. Paul, YonkersSt. Peter, PoughkeepsieSts. Peter & Paul, Staten IslandSts. Philip & James, BronxSt. Rita, Staten IslandSt. Thomas Aquinas, Bronx Student's Name at Time of Attendance: Date of Birth: Grade at end of 2019 - 2020 academic year: Contact Information Name: Address: City, State, Zip: Phone: Email: Relationship to Student: Record Mailing Address (if different from above) Name: Address: City, State, Zip: Authorization Digital Signature: Date: Please email email@example.com with any questions.