Students in the Word - WIS Registration
SCHOOL YEAR: 2021-2022 (2nd Semester Only)
NOTE: Only one student per registration submitted; a registration form must be completed for each student.

Released-Time Bible Education Student Registration & Permission to Leave School to Attend Released-TIme Religious Instruction Form

Students in the Word is a Released-Time Bible Education Elective class offered to Waccamaw Intermediate School Students, GRADE 6 ONLY. Students in 4th and 5th grades may not take the class. SITW is a one semester elective class.

Sponsoring Organization:
Students in the WORD, Inc. (Christian Released-Time Bible Education)

Responsible Party:
Students in the WORD Board of Directors/Executive Director, Jennifer Kaylor 843-318-6362

Mailing Address:
P.O. Box 163, Pawleys Island, SC 29585

Location of Instruction:
St. Paul's Waccamaw United Methodist Church, 180 St. Paul's Place, Pawleys Island, SC 29585
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REGISTRATION INFORMATION
Released-TIme Bible Education Student Registration Form
Student First Name *
Student Last Name *
Grade in 2nd Semester, 2021-2022 School Year *
Date of Birth *
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Parent/Guardian First Name *
Parent/Guardian Last Name *
Mailing Address *
City *
State *
Zip Code *
Parent/Guardian Phone Number *
Additional Parent/Guardian Phone Number
Parent Email Address *
Additional Parent Email Address
Student's Health Issues and/or Special Needs
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 Students in the Word classes? *
Who referred you to Students in the Word?
PARENTAL/GUARDIAN PERMISSION & WAIVER
Permission to Leave School to Attend Released-TIme Religious Instruction Form

Please permit my child, the above-named student, to leave Waccamaw Intermediate School and attend Released-Time Religious Instruction under the conditions set forth on this permission form. My child will be escorted off school property and returned on time by the sponsors of the Released-Time program. The sponsors will carry liability insurance and will be legally responsible for my child when he/she is off District property for the program.

If any emergency, medical procedures, or treatment are required while my child is going to, participating in, or returning from the Released-Time program, I consent for my child to be transported (or for transportation to be arranged for my child), and for my child to receive medical treatment at my expense.

I release, waive, and further agree to indemnify, hold harmless, or reimburse the Georgetown 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.

Students in the WORD, Inc. offers classes without regard to race, religion, sex, national origin, or handicap. All students must have parental permission and be escorted off school property and returned each period by Students in the WORD staff. Students in the WORD carries all necessary insurance, and is legally responsible when students leave school property. Classes are offered during the school day, however Students in the WORD is not part of the public schools. The school does not endorse or oppose Students in the WORD, however they accommodate the wishes of parents to release their children for classes.

By signing below, I understand that Students in the WORD has adopted the discipline code of my child’s school and that my child may be removed from the Students in the WORD program for violations. I hereby give Students in the WORD, their legal representatives and assigns, those acting with permission, or their employees, the right and permission to copyright and/or use and/or publish, and republish photographic pictures of my child, including the use of any printed matter in conjunction therewith.
I confirm that I have read the above "Permission & Waiver" form, and agree to the terms and conditions described in it. *
I understand that in addition to submitting this registration form to Students in the Word, I must also notify my student's Guidance Counselor at WIS of my student's desire to take this released-time religion elective. *
I request that my student be released from school during an elective class period to attend a Christian Released-Time Education class offered by Students in the Word *
SIGNATURE BLOCK
By affixing my signature to this document, I certify that I 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
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