Sign Up Form:

Student Information:

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address: Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

DOB: REQUIRED Please fill out this field. Please enter valid data.

Sex: REQUIRED Please fill out this field. Please enter valid data.

Age: Please enter valid data.

Current School: Please enter valid data.

Current Grade: Please enter valid data.

Please select which event you would like to participate in July: ACT and SAT Prep- July 8-10 ACT and SAT Prep- July 15-17 Art- July 8-10 Beginner's Photography- July 22-24 (Class size limited to 10) Esports- July 8-10 Esports- July 22-24 Theater- July 22-24 Strength and Conditioning- July 15-17

First Parent/Guardian Information:

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address: Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Address is the same as the students? Yes

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Emergency Information:

Allergies: Please enter valid data.

Medical Conditions: Please enter valid data.

Physician: Please enter valid data.

Phone Number Please enter a phone number.

Preferred Hospital: Please enter valid data.

Insurance Carrier:

Policy # Please enter valid data.

Group # Please enter valid data.

Emergency Contact/Pickup Alternatives:

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Relationship to student: Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Print/Electronic Media:

O'Connell College Preparatory School may wish to publish examples of student projects, photographs of students, and other work on the internet via the school's website and social media platforms, and/or print media. Granting permission for your child to participate and/or appear in any such media automatically releases OCPS and the archdiocese of Galveston-Houston from any monetary claims and/or any liability arising from the use of said photograph/publication video.

Parents/Guardian permission for student to participate in above described media publishing:

Please choose one: Granted Not granted

Parent/Guardian Signature: REQUIRED Please fill out this field. Please enter valid data.