Registration and Release for Bible Break - WRE in Shenandoah County
This is a program which will be providing religious education in the Christian faith once a week. It is understood that this child will be transported from the school premises by bus for up to an hour and in the care of a teacher, an aide, bus driver, and volunteers.
Email *
Child's Name *
Date of Birth
Age *
Address *
School that the child is attending
Grade level
Parents / Guardian Name
Day time phone number
Cell Phone number
Emergency Contact name
Emergency Contact  phone number
Emergency Relationship
Special medical needs
Which facility will your child attend? (This is mainly for the home-schooled students.)
I agree to the exchange of information between my child's school and the Weekday Religious Education program.
My child may be photographed and/or videotaped during activities of WRE. This photo release gives the WRE organization permission to photograph your child and release said photos for publication both online and/or in print media. I understand that photographs and videos may be used to promote the program. *
Please be aware that

·        Participation in Weekday Religious Education is voluntary and provided at no cost to parents.

·        If arrangements have been made for your child to leave school early (i.e. doctor’s appointment) he/she will remain at the school.

·        Students will be responsible for any class work missed during the time they are released from school.

·        You authorize any required medical treatment until such time you can be reached in case of emergency.

                        PO Box 634
                        Woodstock, VA  22664

Weekday Religious Education will follow whatever closures are made by SCPS.

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