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Enrollment Form for Student In
Kindergarten Through Seventh Grade
To the CBM Ministries’ Staff: I wish to enroll my child,-(full name), in the released time bible program classes sponsored by CBM Ministries. Signature of parent or guardian_ Parent’s Name (please print) ___ Address__ Date — /_/_Phone_Grade_
To the School Officials: 1 hereby request that my child,__ be excused from the school classes for . one forty-five minute class per month for religious instruction sponsored by CBM Ministries, Inc. I understand that my child will be walked, by a CBM staff member, to the Rolling Chapel parked near the school. I understand that my child will be transferred from the school’s supervision, control and liability to the supervision, control, and liability of CBM Ministries during the time he/she is attending or going to and from the released time classes. Signature of Parent or Guardian_. __ Parent’s Name _____ Date _ Please mail both parts of this form to: CBM Ministries, P.O. Box 1351, Culpeper, VA 22701
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