Russell County Middle Focus Point Registration Form

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Who: Russell county Middle School Students

What: A non-denominational Bible based after-school program

When: Fridays- April 12th, 19th, 26th after school until 4:00pm

Where: Russell Springs Middle School Library

Why: We teach the truth & hope found in the Bible. This basic foundation of faith will help children their entire lives.

How: Submit 1 registration form below for each child attending or print and complete the paper registration form and return to the Coordinator. Please remember to hit "submit" at the end of the form.

Russell County Middle - Focus Point - Spring 2024

Child's First Name *

Child's Last Name *

Grade *

School Teacher *

Parent/Guardian Name *

Street Address *

Home Phone Number

Cell Phone Number *

Email Address *

Emergency Contact Name and Phone Number (after school until 4pm) *

Allergies/Special Concerns *

Yes

Required

If yes, please explain

I would like to:

Volunteer

Donate Snacks

Does your child have a bible at home?

Yes

Please check if you DO NOT want a photo of your child to be used in newspaper articles, newsletters, or on our Kids For Christ Website or facebook page.

My child has persmission to walk home after the program.

By typing my name below, I give my child permission to attend the after-school Focus Point Bible Study. I understand I must confirm all Bible Study plans with his/her school teacher in advance. I assume all risks and hazards incidental to Bible Study participation. *

I agree to the statement above.

Required

Parent Signature *

Date Signed *

YYYY

This program is voluntary and is NOT affiliated with the Russell County Public School District, Jamestown, KY

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