CLASS REGISTRATION

Thank you for taking the time to register to your child to attend the Bible Released Time Education program in your city. We are humbled to be part of your child's spiritual growth during the school day.

CLASS REGISTRATION

Parent/Guardian First Name

Parent/Guardian Last Name

Phone Number

Preferred Method of Communication

Text

How many students are you registering for?

What school district does your child(ren) attend?

Student Information

Student's First Name

Student's Last Name

Student's Birthdate

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Student's Grade Level

Allergies

Emergency Contact's Full Name

Emergency Contact's Phone Number

Consent Form

Name of Parent/Legal Guardian giving consent to participate in the KHM Released Time Bible Education program (DIGITAL SIGNATURE)

I approve of the above named student participating in the KHM Released Time Bible Education program, and by clicking yes I attest that I am the parent or legal guardian of the above named student.

Yes

I the above named Parent/Legal Guardian acknowledge that this consent is good for the entire time the student is enrolled in the KHM Released Time Bible Education program, and may be withdrawn at anytime with written notice.

Yes

Photo Consent - Do you consent for any pictures taken throughout the event to be used in any advertising post online on behalf of KHM?

Yes

I consent my child being transported by bus to the KHM Released Time Bible Education program location.

Yes

Would you be interested in volunteering with KHM at your child's school?

Yes

Anything else you would like to share?

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CLASS REGISTRATION