Released Time Christian Education                   2023-2024 Registration Form
A confirmation will be emailed to the contact provided in the form below.  For any question, please contact us by emailing:

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Email *
Parent/Guardian First and Last Name: 
Home Address: Street, City, Zip *
Parent/Guardian Cell Phone Number (will be used for parent/teacher contact): *
Student's First & Last Name: *
Preferred method for teacher communications? *
What school does your child attend? *
Name of student's teacher?  *
What grade is your student in? *
Does your student have any allergies or health issues we should know about? *

Released Time Christian Education occasionally photographs the children in the program. Their pictures may be used in our: annual newsletter, brochure, website or social media. At times, the children’s first names and comments may also be included. If you agree to allow your child to be included in pictures, please do so by choosing “I Agree”. Photographs will be used solely in the promotion of the Released Time program.


In the event of an extreme campus emergency and to ensure the safety of students, the RTCE bus may be driven to the nearest police/sheriff/fire station or the schools off campus evacuation site. When the campus has returned to normal, the School Office Staff will notify  local authorities to determine student dismissal. School Office Staff will direct students and parents.

**Type YOUR name below**


Waiver for COVID-19 and other variants 

Chino Valley Released Time Christian Education plans to keep your children safe!

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child and I may be exposed to or infected by COVID-19 and its variants by attending and/or participating in the Chino Valley Released Time Christian Education program. I acknowledge that such exposure or infection may result in illness, disability or other issues resulting to my child's participation in the  program.

I voluntarily and knowingly agree to assume all of the forgoing risks and accept sole responsibility with my child's attendance and or participation in the Chino Valley Released Time Christian Education program. My child and I willingly agree to comply with the preventative measures and conditions for attendance to protect against the spread of COVID-19 and its mutations.

On behalf of my child, I hereby release and forever discharge and hold harmless the Chino Valley Released Time Christian Education program and its volunteers, board members or any other representative from all liability for illness or other issues related to my child's participation in the program.

*Type YOUR name below*


***Parent/Guardian Consent***

By typing your name below and submitting this permission form, you agree that YOU ARE THE STUDENTS LEGAL PARENT OR GUARDIAN and give permission for your child to be released from class for the Released Time Christian Education training program. 

I am acknowledging that my child will attend the program beginning October 2, 2023 and ending April 26th, 2024

I am consenting that my child will be met in the school office and signed out and will be returned and signed in at the office by the Released Time volunteers.

My child will be walked to the nearby shuttle bus in front of or near the school for this educational training. The shuttle bus will be used as a mobile classroom and no children will be driven on the bus. 

*Day and time vary by school.

**In the event that the bus reaches capacity at your child's school, he/she will be placed on a waitlist. 

I have read and completed the above information and by my permission, agree that my child may participate in the Released Time Christian Education Program.

**Type YOUR name below**

A copy of your responses will be emailed to the address you provided.
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