Student Registration Form

Must be filled out by a parent or guardian. 

    Student Information

    School & Grade

    Student Health Information

    My child has:

    A life-threatening condition

    An Epi-pen at school. If so, please contact us at 1-800-851-8179

    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 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 hereby give School Time Bible Ministries and the church the right and permission to take, use, and/or publish photos and videos 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 social media pages 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