JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Club 3:16 Permission
What is Club 3:16?
Started by students last year, Club 3:16 is a place for students
grades 3-5th
to meet and greet with students who are interested in exploring and growing their faith in Jesus. The Club was named by students after the scripture passage John 3:16.
Please see more information about club information by
clicking here
.
Teacher Club Sponsor:
Ms. Allyce Burdette
Parent Head Sponsor:
Mrs. Melanie Derry
Email for questions about club:
MelanieDerry@gmail.com
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Name (First and Last):
*
Your answer
Parent(s) Name(s) and Contact (###)###-####
Example: Henrietta Alvarez (804)612-2233
Henry Alvarez (804)612-3322
*
Your answer
Student Classroom Teacher:
*
Your answer
I give my child permission to attend Club 3:16 during the 2023-2024 school year.
*
Yes I give my child permission.
I have clicked the link and read the information about club- including where to drop off and club dates and times.
*
Yes
No
Anything important to know about your child? (please include allergy information)
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Chesterfield County Public Schools.
Report Abuse
Forms