CLC Application/Permission Form 2019 - 2020 School Year
Greene County Christian Learning Center
Parent/Guardian's first and last name *
Your answer
Parent/Guardian's home phone number *
Your answer
Parent/Guardian's cell phone number *
Your answer
Parent/Guardian's email address *
Your answer
Street Address, Apt # or PO box *
Your answer
City, State *
Your answer
Zip code *
Your answer
Student's first and last name *
Your answer
Grade level the student will enter this coming year *
Select the school your child will attend during the coming school year *
Students will be allowed to select from the following courses during the 2019 - 20 school year
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By clicking "I agree", you (Parent/Guardian) give your child (Student) permission to participate in the Greene County Christian Learning Center (also referred to as "CLC") courses offered at his/her school for the 2019-20 school year, and to ride in the transportation provided by the CLC on approved field trips. CLC classes will meet at the ATLAS Center. NOTE: NGA classes will meet on the school campus. LOA classes will meet at Lakeside Church. *
By clicking "I agree", you (Parent/Guardian) also give permission to the CLC instructor to report your child's (Student's) grades to the appropriate school, upon completion of the class. *
By clicking "I agree", you (Parent/Guardian) also give permission to the CLC and ATLAS Ministry, Inc. to use photographs of your child (Student) taken during class, CLC related functions, and/or ATLAS Ministry related functions for use in media/publications. *
Today's Date *
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