I (Parent / Guardian name; please PRINT) ______________________________________________________
give my permission for my Booker T. Washington School K-8 (BTWK-8) public school student
(Student’s name; please PRINT) _____________________________________________________________
Grade: _______ Teacher’s name (please PRINT) ________________________________________________
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to attend Purpose Club Release Time Bible Education (“RTBE”) classes sponsored by School Ministries Alabama (“SMA”), with classes held during school hours at Green Liberty Baptist Church, 121 5th Avenue South, Birmingham, AL 35205, and fully submit my student to class attendance requirements imposed by Birmingham City Schools and BTWK-8. I understand that transportation to and/or from the Purpose Club class at Green Liberty Baptist Church is not provided by SMA, BTWK-8, or Birmingham City Schools, and that my child will walk to and from classes accompanied by adult SMA escort volunteers and/or staff. This is my consent to allow my student to attend RTBE classes for the 2024-2025 School Year.
I understand that this class is not designed to conflict with required core classes and that my student is responsible for school class assignments that may be missed during RTBE classes. I understand that a parent/guardian may remove their student from RTBE classes at any time with written notice. I understand that the RTBE program may remove my student from the class if circumstances require.
I understand there may be occasions when photos or video may be taken during RTBE classes or special events such as field trips. I consent for School Ministries and its agents to use and publish, without charge, photos, videos, print material or other media that may include images and words of and about my child.
For students required to be accompanied by a School nurse for off-campus field trips or other excursions, an authorized family member of the student must volunteer to accompany your child to RTBE classes. Food allergies do not require a School nurse to accompany your child; however, that information is requested below so we are aware and prepared if necessary. Please complete the following:
A school nurse ___IS ___IS NOT required to accompany my child on field trips or off-campus events.
___ My child DOES NOT have any food allergies.
___ My child DOES have the following food allergies: _________________________________________
_______________________________ _____________
Parent/Guardian Signature Date
_______________________________ _________________________________________
Parent/Guardian Phone Number PRINT Parent/Guardian Email
_______________________________ _______________ ____ ________
PRINT Parent/Guardian Street Address City State ZIP
_______________________________ _____________
Student Signature Date
