DeKalb County Released Time

Student Registration Form

We are so excited that you have decided to allow your child to join us for the 2011-2012 school year.

In order to enroll your child, you must be able to answer YES to all of the following questions:

1. Are you the parent or legal guardian of the child that is being enrolled?

2. Does your child attend one of the schools in Dekalb County that is currently participating in the Dekalb County Released Time Program?

Collinsville, Crossville, Fyffe, Geraldine, Henagar, Ider, Moon Lake, Plainview,  Ruhama, Sylvania, Valley Head

 

3. Is your child presently enrolled in grades 2-6 at any of the schools listed above?

If you were unable to answer YES to any one of the preceding questions, please click here to return to the Dekalb County Released Time page.

If you were able to answer YES to ALL of the above questions, please continue with the registration form.

Name of Parent or Guardian (First and Last Name): *


















I,

request that my child be released from the class period chosen by the school, to attend a Bible Education class offered by Dekalb County Released Time (DCRT). DCRT offers classes without regard for race, religion, sex, national origin, or handicap. All students must have parental permission and be escorted off school property and returned each period by DCRT staff. DCRT carries all necessary insurance and is legally responsible when students leave school property. Classes are offered during the school day but DCRT is not part of the public school. The school does not endorse or oppose DCRT but accommodates the wishes of parents to release their children for its classes. Children will be expected to attend all Released Time classes unless a parent of guardian signs to release them from the program. Children cannot be picked up by a parent or guardian at the Released Time class site.

By submitting this online registration form, I understand that I am the parent or legal guardian of the child being registered. I understand that DCRT has adopted the "Three Strikes You're Out" discipline code and that my child may be removed from the DCRT program for violations. I give permission for my child to participate in entrance and exit evaluation surveys. I hereby give DCRT the right and permission to copyright and/or use, and/or publish, and republish photographic pictures of my child. I also give DCRT permission to transport my child to class in case of rain or inclement weather.

Relationship to Student: *
E-mail Address: *
Students Last Name: *
Students First Name: *
Students Date of Birth: * Select Date
School Student Attends: *
Grade in School: *
Teachers Name: *
Has your child ever attended Released Time classes at a different school? *Yes
No
If so, which school?
Does your child attend a church on a regular basis? *Yes
No
If so, which church?
Students mailing address: *
Students City: *
State:
Zip Code: *
Emergency Contact #1 *
Emergency Contact #2
Please list any health problems or special needs this student may have:
Todays Date * Select Date
* Required
 

 

Ponderosa Student Ministries is a 501(c)3 Non-Profit Organization
Ponderosa Student Ministries is an affiliate of Children's Bible Ministries with locations from South FL to VA
Click here to subscribe to our Email list if you want to stay informed about this ministry and camp info! We promise your email address will not be sold or shared with anyone else.