Anchor Learning Center Permission Form Fall 2026-Spring 2027
SCHOOL YEAR: 2026-2027

(NOTE: Only one student per registration may be submitted; a registration form must be completed for each student.)

A Released Time Bible Education program is being offered to students of Farragut High School.  Released Time Bible Education classes are available to students in grades 9th through 12th. We invite all students to attend.  If your child attends Farragut High School and would like to participate, please complete this registration/consent form and return to the Anchor Learning Center.  Completing this form does not guarantee your student's spot in the class, but all students must have this on file before taking part in any ALC class.  Because we are a Released Time Bible Education program, Farragut High School is not allowed to release this private information to us.  The ALC board of directors is requesting this information in order to properly place students as well as for emergency purposes that may occur in our classes during the school year.  

Released Time Bible Education Class Schedule / Location:
Released Time Bible Education Classes will occur every school day during the designated class period. Classes will be held during 1st, 2nd and 3rd blocks (last lunch). School holidays will be observed. Classes will be held on the campus of Faith Promise Farragut, 144 West End Avenue, Farragut, Tennessee 37934, United States.  The method of transportation will be as follows: students will walk from FHS to Faith Promise Farragut and will enter through the back door of the building (Anchor Learning Center will provide transportation if notified by the parent).

Courses Offered

Released Time Bible Education--Introductory Old Testament (Fall Semester)

This class designed to increase students’ biblical literacy by exploring the major stories, themes, and books of the Old Testament and how they ultimately point to Jesus. Students will study the Law, History, Poetry, and Prophets, gaining an understanding of God’s character, His covenant relationship with His people, and His redemptive plan woven throughout Scripture. In addition to classroom learning, the course includes elements of discipleship such as Scripture memory, learning how to pray, developing skills for studying the Bible on their own, and participating in service projects that encourage students to live out their faith in practical ways.

Released Time Bible Education--Introductory New Testament (Spring Semester)

This class is designed to increase students’ biblical literacy by studying the life, teachings, death, and resurrection of Jesus as recorded in the Gospels, as well as the formation and spread of the early Christian church in the book of Acts. Students will explore key themes of the New Testament, including the kingdom of God, salvation, grace, and discipleship, and will gain an introduction to Paul’s letters and other epistles that address how followers of Jesus are to live out their faith. Alongside classroom instruction, the course emphasizes spiritual formation through Scripture memory, learning how to pray, developing skills for studying the Bible independently, and participating in service projects that encourage students to live out biblical truth in everyday life.


Sponsoring Organization:
Anchor Learning Center (Christian Released-Time Bible Education)

Responsible Party:
Anchor Learning Center Executive Director, Sherry Shope (sherry@alcfarragut.com)
Anchor Learning Center Teacher and Director of Program Development, Tyler Lane (tyler@alcfarragut.com) and Board of Directors   

Location of Instruction:
Faith Promise Farragut, 144 West End Avenue, Farragut, Tennessee 37934, United States
Sign in to Google to save your progress. Learn more
Email *
Student First Name *
Student Last Name *
Student email *
Grade in 2026-2027 School Year *
Course Requested in Upcoming School Year *
Required
Date of Birth  *
MM
/
DD
/
YYYY
Parent/Guardian First Name *
Parent/Guardian Last Name *
Mailing Address *
City *
State *
Zip Code *
Parent/Guardian Phone Number *
Parent Email *
Additional Parent Email
For FHS students, how will your student normally get to school in the morning?
Clear selection
Emergency Contact - Name of contact if parent/guardian is unavailable
 *
Emergency Contact - Relationship to Student
 *
Emergency Contact Phone Number
 *
Student's Church or Youth Group (if applicable)
How did you hear about Anchor Learning Center classes?
 *
Medical Release Form
Preferred Hospital  *
Primary Insurance Company  *
Policy Number *
List all allergies, medication(s) being taken and other important health information which may affect the education of the student (including any possible need for transportation to and from Anchor Learning Center to Farragut High School).
List all known academic or behavioral needs your student may have in the classroom.
(Anchor Learning Center does not have access to school records, student IEPs, or accommodations, so any helpful information that the parent/guardian is to share with us is appreciated as we support your student’s educational needs.)
Family Physician 
Family Physician Phone Number
Family Dentist
Family Dentist Phone Number 
In Case of Medical Emergency

I understand that every effort will be made to contact me in the case of an emergency. However, permission is hereby granted to the adult volunteer of your program to authorize treatment by a physician to perform necessary treatment, including injection, anesthesia, or surgery for my child until such time as I can be reached.

Signature Block
By affixing my signature to this document, I certify that  I am over eighteen (18) years of age and am the parent or legal guardian of the student identified herein, and that I give my permission for treatment in the case of medical emergencies.
PARENT / GUARDIAN: PLEASE ENTER FULL NAME BELOW
 *
I request that my student be released from school during an elective class period to attend a Christian Released-Time Education class offered by Anchor Learning Center.
 *
I understand that in addition to submitting this registration form to Anchor Learning Center, I must also notify my student's Guidance Counselor at FHS of my student's desire to take this released-time religion elective.
 *
PARENTAL/GUARDIAN PERMISSION & WAIVER

I hereby authorize and direct Farragut High School to release information about my child upon the request of Anchor Learning Center, including my child’s name, grade level, and contact information. I understand this information is being shared to allow Anchor Learning Center to plan for future class interest and demand, and to otherwise promote the programs and activities of Anchor Learning Center.


I give permission for the student listed above to attend the Released Time Bible Education class of The Anchor Learning Center.


As the parent/guardian, I also understand that this class is not designed to conflict with or replace required credit classes. Students are responsible for school assignments missed during Released Time classes. I also understand that this is a consent form; it will allow my child to attend Released Time until he/she is withdrawn or changes schools.


I further understand that as the parent/guardian, I can remove the child at any point from the program upon written notice, and likewise the program has the right to remove any student from the program for disciplinary issues or for being disruptive.


I, the parent/guardian, understand there may be occasions where video or photos may be taken during classroom instruction or special events such as field trips. I hereby give and assign The Anchor Learning Center and School Ministries and their legal representatives, the right and permission to use and publish, without charge, photographs, videos or other media of this student and his or her image, or likeness taken. These photographs and/or videos may be used in publications, including electronic publications, or in audio-visual presentations, promotional literature, advertising, or in other similar ways.


Anchor Learning Center will carry liability insurance and will be legally responsible for my child when he/she is off Knox County Schools property for the program.
 
I release, waive, and further agree to indemnify, hold harmless, or reimburse the Knox County School District, the individual members, employees, and representatives thereof, from and against, any claim which I, any other parent or guardian, any sibling, the student, or any other person, firm, or corporation may have or claim to have, known or unknown, directly or indirectly, for any losses, damages, or injuries arising out of, during, or in connection with my child’s participation in Released-Time for Religious Instruction, or the rendering of emergency medical procedures or treatment, if any.

Anchor Learning Center offers classes without regard to race, religion, sex, national origin, or handicap.  Anchor Learning Center carries all necessary insurance, and is legally responsible when students leave school property.  Classes are offered during the school day, however Anchor Learning Center is not part of the public schools.  The school does not endorse or oppose Anchor Learning Center, however they accommodate the wishes of parents to release their children for classes. By signing below, I understand that Anchor Learning Center has adopted the discipline code of my child’s school and that my child may be removed from the Anchor Learning Center program for violations.


I confirm that I have read the above "Permission & Waiver" form, and agree to the terms and conditions described in it.
 *
Tardy Policy (added January 2025)

Students are expected to be in first block class at 8:30am to be counted on time.  For second block class, students are expected to be in class within 3 minutes of the Farragut High Class start time in order to be counted present and on time.  For example, if second block begins at Farragut High School at 10:07, students are to be in ALC class by 10:10 (they are dismissed at 9:59 from FHS so 10:10 is about the latest any of them show up.  Most show up between 10:06 and 10:08).  After that time, they will be counted tardy.  If a student is counted tardy, they will be notified by the teacher and will need to complete a "time for time" assignment posted on Canvas.  This assignment is due within one week of the tardy date.  Failure to complete this assignment will result in the student receiving a "time for time" Wednesday referral.  The student will need to attend ALC at Faith Promise from 8:00-8:45 the following Wednesday.  
A student can have the tardy excused if they present a note from a parent or FHS staff member.  
If a student is found to be skipping class without parent or Farragut staff permission, the student will be expected to attend 2 "time for time" sessions at the Faith Promise classroom the following Wednesdays from 8:00-8:45am.  
If a student misses more than 15 minutes of a class, they will be counted absent for daily attendance, as per the KCS policies.  Every daily absence is communicated to the parent via the ALC ministry assistant.
The Anchor Learning Center can provide daily transportation between 1st and 2nd block classes, and will depart and pick up at designated times to prevent excuses related to tardies.

I understand the new tardy policy and agree to the terms and conditions described in it. 
 *
Signature Block
By affixing my signature to this document, I certify that  I am over eighteen (18) years of age and am the parent or legal guardian of the student identified herein, and that I have authority to authorize the student's participation in the program.

PARENT / GUARDIAN: PLEASE ENTER FULL NAME BELOW
 *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of anchorlearning.center.

Does this form look suspicious? Report

Google Forms