Student Registration Form

Must be filled out by a parent or guardian. 

Student Information

Student Health Information

My child has:

A life-threatening condition

An Epi-pen at school. If so, please contact Leigh at 803-348-5660

Medication at school that they may need during class

Parent or Guardian Information

Emergency Contact Information

   I am the parent or legal guardian of this student.

I request that my child be released from school during an elective class period to attend off-campus
Bible classes. The Bible classes are offered without regard for race, religion, sex, national origin or
handicap. All students must have parental permission and will be escorted off school property and
returned after each period by church staff. The local church carries all necessary insurance and is
legally responsible when students leave school property. The Bible classes are offered during the school
day, but are not part of the public school. The school does not endorse or oppose the Bible class but
accommodates the wishes of parents to release their children for the Bible class.

I Agree

I understand that local churches have adopted the discipline code of my child’s school and that my child
may be removed from the Bible class program for violations. I give permission for my child to
participate in entrance and exit evaluation surveys. I hereby give School Time Bible Ministries and the
church the right and permission to take, use, and/or publish photographic pictures or video footage of
my child. These pictures will be used to promote the School Time Bible Program, to recruit volunteers
for future programs or to post on the School Time Bible Ministries website or Facebook page to inform
and encourage the prayers of our many faithful supporters. I understand that my child’s name will not be
used in any way with these pictures to safeguard identities.

I Agree