Prattville Junior High School
Parent/Guardian Student Permission Form

I, the undersigned Parent/Guardian, give permission for my student enrolled at Prattville Junior High School ("PJHS" or "the school" ) Fall Term 2025 to attend Extended Learning Opportunity ("ELO") Bible education sponsored by School Ministries Alabama ("School Ministries") held off campus during PJHS 1st Period at Prattville First Methodist Church ("First Methodist"), 100 East 4th Street, Prattville , AL 36067.

This is my consent to allow my student to attend this ELO Bible class during the 2025-2026 school year. I understand that their transportation to and from the school to First Methodist for classes will be provided by First Methodist or School Ministries, not PJHS or Autauga County School District.

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 ELO Bible classes. I understand that I may withdraw my permission for my student to attend ELO Bible classes at any time, and agree to timely inform the school and School Ministries of their withdrawal. I understand that School Ministries may withdraw any student from the class if circumstances (i.e., unresolved behavioral issues) require, and that I will be timely informed in that event.

I understand there may be occasions when photos or video may be taken during this ELO Bible class; 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 or about my child.

I understand that any supporting educational accommodations or interventions provided to my student by Prattville Junior High School or Autauga County School District are not available or otherwise provided to my student during their attendance at this specific ELO class, including if my student is required to be accompanied by a school nurse or paraeducator during the school day. 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:

My child has the following food allergies.

Student's First Name

Student's Last Name

First and last name entry will count as the Student's electronic signature.

Today's Date

Student's Birthdate

Birth Day

Birth Year

Mother's First Name

Mother's Last Name

Today's Date

First and last name entry will count as your electronic signature.

Mother's Phone Number

Mother's Email

Father's First Name

Father's Last Name

Father's Phone Number

Father's Email

Parent's Street Address*

After review and acceptance by SMA, a PDF copy of your completed form will be sent to the email address provided.

Thank you for your patience.

By submitting this form with my electronic signature I confirm my acceptance of its terms and conditions.

Thank you for submitting your student's permission form. If you have any questions or concerns, please email mark@smalabama.org.

If you have any questions, please email mark@smalabama.org.

Prattville Junior High School Parent/Guardian Student Permission Form

Parent's Street Address*

Prattville Junior High School
Parent/Guardian Student Permission Form