Skip to content

St. Mary Parish Teen CERT Disaster Preparedness Workshop Tuesday, July 7, 2026

Sponsored by Volunteer Louisiana and the Office of Lt. Governor Billy Nungessor

Please answer the following questions to confirm your child's enrollment to attend. This information will be used for documentation of those participating in the Community Emergency Response Team (CERT) workshop and parental consent.
1.Child's Name (First and Last)(Required.)
2.Parent or Guardian Name (First and Last)(Required.)
3.Registrant Home Address(Required.)
4.Parent or Guardian Phone Number(Required.)
5.Parent or Guardian Email Address(Required.)
6.Please check whether the person that you are registering is:(Required.)
7.The grade that the registrant will be entering Fall 2026(Required.)
8.School the student will be attending Fall 2026(Required.)
9.Does the registrant have any food allergies or dietary restrictions? Explain...(Required.)
10.Additional Comments or Special Instructions:
11.Permission and release
I hereby give consent for my child, named above, to participate in the TEEN CERT Training Program organized by Teche Health/Volunteer Louisiana /St. Mary GOHSEP/Broussard-Harris Recreation Center. I understand that this program provides emergency response and disaster preparedness skills.

I acknowledge that while every precaution is taken to ensure safety, there may be inherent risks in certain activities. I give permission for my child to participate in all activities associated with the program and release Teche Health/Volunteer Louisiana /St. Mary GOHSEP/Broussard- Harris Recreation Center, its employees, and volunteers from liability for any injury or unforeseen circumstances during the program.(Required.)
Current Progress,
0 of 11 answered